{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T04:16:54Z","timestamp":1697343414881},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,2,1]],"date-time":"2012-02-01T00:00:00Z","timestamp":1328054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"AstraZeneca R&D"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine trends and predictors of clopidogrel and proton pump inhibitor (PPI) coprescription with low\u2010dose acetylsalicylic acid (ASA) prescribed for secondary cardiovascular or cerebrovascular disease (CVD) prevention in UK primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients aged 50\u201384\u2009years who received a first prescription for low\u2010dose ASA for secondary CVD prevention in 2000\u20132001 (<jats:italic>n<\/jats:italic>\u2009=\u200910 330) or 2006\u20132007 (<jats:italic>n<\/jats:italic>\u2009=\u20098154) were identified in The Health Improvement Network UK primary care database. Clopidogrel or PPI coprescriptions received within 15\u2009days after the first low\u2010dose ASA prescription were ascertained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clopidogrel coprescription with low\u2010dose ASA increased from 1.6% to 25.2% between the two study periods; PPI coprescription increased from 11.6% to 28.3%. Low\u2010dose ASA indications of myocardial infarction [odds ratio (OR) 11.7, 95% confidence interval (CI) 10.2 to 13.4] and unstable angina (OR 1.73, 95%CI 1.09 to 2.75) were positive predictors of clopidogrel coprescription in 2006\u20132007, relative to chronic ischaemic heart disease. Patients at high risk of upper gastrointestinal bleeding were more likely to receive a PPI than those at lower risk in 2006\u20132007 (OR 4.36, 95%CI 3.93 to 4.84). In this period, 65.5% of patients who required a clopidogrel coprescription according to guideline recommendations received one, and 44.3% of patients at high risk of upper gastrointestinal bleeding received a PPI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clopidogrel and PPI coprescription with low\u2010dose ASA increased markedly between 2000\u20132001 and 2006\u20132007; however, many patients on low\u2010dose ASA did not receive the recommended coprescriptions at the end of the study period. 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