Preventive medicine use for gastrointestinal bleeding varies by specialty; improved prescribing guidelines needed

Proton pump inhibitors are common and effective medications for the treatment of stomach acid-related diseases, including peptic ulcers that can lead to gastrointestinal bleeding. While proton pump inhibitors are commonly prescribed, for patients at high risk of a gastrointestinal bleed they may be underutilized. Researchers explored the prescribing practices and barriers doctors face when deciding whether to implement gastroprotection. They interviewed five primary care physicians, four cardiologists, three gastroenterologists, and three vascular surgeons within a single institution to produce qualitative results for this study.

Most primary care physicians, gastroenterologists and vascular surgeons seldom prescribed gastroprotection. Cardiologists varied most in their use of proton pump inhibitor gastroprotection. Other health care professionals never prescribed proton pump inhibitors. Barriers revolved around knowledge, decision processes and professional roles in prescribing proton pump inhibitors.

Knowledge about prescribing guidelines was greatest among cardiologists and gastroenterologists and low among primary care physicians and vascular surgeons. Barriers operated differently across specialties. Multi-component interventions will likely be necessary to improve guidelines-based use of proton pump inhibitors to prevent upper gastrointestinal bleeding.