Barriers to Guideline-Based Use of Proton Pump Inhibitors to Prevent Upper Gastrointestinal Bleeding

Congratulations to the authors who have identified an array of challenges to the highly cost-effective utilization of PPIs to reduce the risk of life threatening gi bleeding among NSAID users. Cox-2 inhibitors were developed to address this unmet need for effective anti-inflammatory therapy with reduced GI risk -recognizing a clinical problem that is the most common serious adverse medication side effect in practice. Ongoing efforts focused on barriers the investigators' have identifed will hopefully address the failure of clinicians to protect patients from these and other adverse medication side effects.