A 68-year-old man presents to his general practitioner for a routine review of his medications. He has a history of osteoarthritis, for which he takes naproxen regularly, and atrial fibrillation, for which he takes aspirin and warfarin. He has no current symptoms but mentions occasional dyspepsia. He has no history of gastrointestinal bleeding. He does not drink alcohol or smoke. His last blood tests three months ago were unremarkable.
What is the most appropriate next step to reduce this patient’s risk of upper gastrointestinal bleeding?
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