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You are here: Home / Resources / SystmOne Resource Centre / SystmOne Specialties / Gastroenterology

Gastroenterology

The CDRC system has a number of features to help clinicians ensure patients are offered appropriate gastroprotection when taking relevant medication. 

The main classes of medication that are associated with a need for gastroprotection are: 

  • Anticoagulants 
  • Antiplatelets 
  • Corticosteroids
  • NSAIDs 

Accessing CDRC resources on SystmOne

To access the below resources you will need to be a member of the DCS group on SystmOne. To do this, please follow the instructions on the CDRC SystmOne Access webpage.

Gastroenterology Reports

An overall report is available to show all patients that have been detected, where gastroprotection might be considered. 

? GI Bleeding Risk – Consider Gastroprotection #

This report is found in the folder CDRC Quality > Gastroenterology

Further reports are also available for individual medications: 

CDRC Quality > Cardiovascular > ? Antiplatelet Safety 3: Consider Gastroprotection # 

CDRC Quality > Endocrinology > ? Corticosteroid Safety 1: Consider Gastroprotection # 

CDRC Quality > Haematology > ? Anticoagulation Safety 09 – High GI Bleed Risk – no gastroprotection # 

CDRC Quality > Rheumatology > ? NSAID Safety 5: Consider Gastroprotection # 

If prioritisation is needed, more detailed reports are available with increasing numbers of risk factors: 

*1-1043810 」 do 」 Ise60U- L: 
*1-1043810 」 do 」 Ise60U-t— 
*1-1043810 」 do 」 Ise60U-E— 
*1-1043810 」 do 」 Ise60U-V=
Antiplatelet Safety - On antiplatelet (repeat) but no gastroprotection # 
Antiplatelet Safety - On antiplatelet (repeat) but no gastroprotection - PHx PUD/GI Bleed # 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
Antiplatelet Safety- On Antiplatelet- Risk factors for bleeding 
- no gastroprotection # 
- no gastroprotection # 
- no gastroprotection # 
- no gastroprotection #
Conicosteroids Safety- On corticosteroid (repeat) but no gastroprotection # 
Conicosteroids Safety- On corticosteroid (repeat) but no gastroprotection - PHx PUD/GI Bleed # 
Conicosteroids Safety- Risk factors for bleeding 
Conicosteroids Safety- Risk factors for bleeding (but no gastroprotection) # 
Conicosteroids Safety- Risk factors for bleeding 
Conicosteroids Safety - Risk factors for bleeding (but no gastroprotection) # 
Conicosteroids Safety- Risk factors for bleeding 
Conicosteroids Safety - Risk factors for bleeding (but no gastroprotection) # 
Conicosteroids Safety- Risk factors for bleeding 
Conicosteroids Safety - Risk factors for bleeding (but no gastroprotection) #
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
NSAIO safety- on NSAIO (repeat 
regular) but no gastroprotection # 
regular) but no gastroprotection - PHx PUD/GI Bleed # 
regular) RF for bleeding 
regular) RF for bleeding 
--1 (not COX2) # 
regular) RF for bleeding (not COX2, but no gastroprotection) # 
regular) RF for bleeding 
(not COX2) # 
regular) RF for bleeding (not COX2, but no gastroprotection) # 
regular) RF for bleeding 
regular) RF for bleeding (but no gastroprotection) # 
regular) RF for bleeding 
regular) RF for bleeding (but no gastroprotection) #
Gastroprotection Template

How to Access:

With the patient’s record retrieved, in the search bar located in the bottom left-hand corner type in ‘Gastroprotection – CDRC’ and select the following template:

Alternatively, press F12 and type in ‘Gastroprotection – CDRC’ in the search bar, this will return the aforementioned template.

Gastroprotection Template:

The Gastroprotection template shows current gastroprotection repeats (if present) and a recommendation to consider gastroprotection if the patient is taking a relevant medication and has risk factors for gastrointestinal bleeding.  The licensed doses for gastroprotection are shown at the bottom of the template. 

Gastroprotection Anticoagulants 
Gastroprotection 
Anticoaaulants 
Antiplatelets 
Conicosteroids 
NSAIDs 
Antiplatelets 
Corticosteroids 
Licensed doses for gastroprotection 
Drug 
Lansoprazole 
Omeprazole 
Esomeprazole 
Pantoprazole 
Rabeprazole 
NSAIOs 
Current Gastroprotection 
! ANTICOAGULANTS ! - consider Gastroprotection 
Licensed dose for gastroprotection 
15-30mg od 
(possibly higher for preventing ulcer recurrence) 
20mg od 
20mg od 
20mg od 
Not licensed

There are links to pages for each of the four main classes of drugs that affect GI bleeding risk. 

Each page shows: 

  • Guidance on gastroprotection for that medication 
  • The relevant medication that may require gastroprotection 
  • A summary of some of the relevant risk factors 
NSAlDs 
CKS Guidance 
To avoid Gl adverse effects try to use the lowest dose for the shortest tim4 
Risk Factors For NSAID Induced Gl ADRs 
• Max dose NSAlDs 
• over 65} 
• History peptic ulcer, Gl bleeding or perforation 
• Concomitant drugs that increase Gl bleeding risk 
• aspirin, steroids, SSRI, duloxetine, venlafaxine and anticoagulants 
• Comorbidity, cardiovascular disease, hepatic or renal impairment 
diabetes, hypenensiom 
• Requirement for prolonged use, including 
• OA or rheumatoid arthritis at any age 
• Chronic low back pain over 45 
Additional Risk Factors 
• NSAID type - lowest risk with ibuprofen 
• Presence of heliocbacter infection 
• Excessive alcohol use 
• Heavy smoking 
Risk Reduction 
NSAID Gastroprotection Information 
Naproxen 500mg tablets 
30 Dec 
No clear record of gastroprotection 
take ta 
! RISK FACTOR FOR BLEEDING ! - SUSPECTED PROLONGED NSAID USE 
! RISK FACTOR FOR BLEEDING ! - ON SSRI 
! RISK FACTOR FOR BLEEDING ! - OVER 65 
Ex smoker 
Alcohol intake 
g unitsmeek 
og Jan 2020 
High risk 
Mod risk 
Low risk 
h/o complicated ulcer or -2 risk factors 
consider COX2* and PPI 
1-2 risk factors 
NSAIO and PPI 
No risk factors 
NSAIO 
*Balance Gl risk against CVD/hear1 failure risk

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