Scenario 1 30 year old male Metal mitral valve replacement Lifelong warfarin Nimesulide following a wrist fracture Estimate the annual risk of GI bleed.

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Presentation transcript:

Scenario 1 30 year old male Metal mitral valve replacement Lifelong warfarin Nimesulide following a wrist fracture Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -Medium Risk. No of Risk Factors-2. Respondent Risk Estimate 2/1,000 patients per year. Proportion favoring PPI

Scenario 2 50 year old female with RA Uses NSAIDs occasionally Coronary artery stenting Aspirin and clopidogrel Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -Medium Risk. No of Risk Factors-2. Respondent Risk Estimate 2/1,000 patients per year. Proportion favoring PPI

Scenario 3 80 year old female IHD. Atrial fibrillation Aspirin, clopidogrel, warfarin Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -High Risk. No of Risk Factors-4. Respondent Risk Estimate 10/1,000 patients per year. Proportion favoring PPI

Scenario 4 60 year old male Low back pain. Rx with NSAIDs Triple therapy for DU aged 51 Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -High Risk. No of Risk Factors-2. Respondent Risk Estimate 10/1,000 patients per year. Proportion favoring PPI - 0.8

Scenario 5 40 year old female DM and hyperlipidaemia. F Hx of IHD Taking daily low dose aspirin Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -Low Risk. No of Risk Factors-1. Respondent Risk Estimate 1/1,000 patients per year. Proportion favoring PPI - 0.1

Scenario 6 80 year old male IHD and CCF Aspirin and clopidogrel Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -High Risk. No of Risk Factors-3. Respondent Risk Estimate 2/1,000 patients per year. Proportion favoring PPI

Scenario 7 50 year old male COPD Taking aspirin and prednisolone Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate - Low Risk. No of Risk Factors-2. Respondent Risk Estimate 1/1,000 patients per year. Proportion favoring PPI

Scenario 8 70 year old female with hip fracture TIA in past – low dose aspirin Now taking NSAIDs for hip pain Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -High Risk. No of Risk Factors-3. Respondent Risk Estimate 2/1,000 patients per year. Proportion favoring PPI

Scenario 9 30 year old female Lifelong warfarin for recurrent DVT Commenced on prednisolone for sarcoidosis Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate - Low Risk. No of Risk Factors-2. Respondent Risk Estimate 2/1,000 patients per year. Proportion favoring PPI

Scenario year old male IHD, taking clopidogrel Rx NSAIDs for osteoarthritis Estimate the annual risk of GI bleed ? PPI prescription Results: Author Estimate -Medium Risk. No of Risk Factors-2. Respondent Risk Estimate 2/1,000 patients per year. Proportion favoring PPI