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Risk factors for nonsteroidal anti-inflammatory drug (NSAID)–associated gastrointestinal bleeding are well defined. The concomitant use of gastroprotective agents (misoprostol or proton-pump inhibitors [PPIs]) can lower that risk, but many patients with risk factors for bleeding inappropriately receive NSAIDs without gastroprotective agents (Journal Watch Gastroenterology May 9 2006). However, use of gastroprotective agents in patients without risk factors has not been well evaluated.
To address this issue, investigators developed a clinical vignette that was distributed, along with a survey, to all 1429 family doctors and general internists, orthopedic surgeons, rheumatologists, and gastroenterologists in Manitoba, Canada. The vignette desc…