NSAID Gastrointestinal Risks Overestimated
NSAID Gastrointestinal Risks Overestimated
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Murthy SK, Kauldher S, Targownik LE
Aliment Pharmacol Ther. 2006;23:1365-1372
Clinical vignettes were mailed to physicians describing patients at low risk for gastrointestinal complications who were candidates for nonsteroidal anti-inflammatory drug (NSAID) therapy. The physicians then were asked to complete a series of questions about their beliefs regarding the gastrointestinal risks associated with NSAIDs. Physician responders were separated into 2 groups based on their responses. "Appropriate prescribers" were those physicians who said they would prescribe an NSAID alone, and "inappropriate prescribers" were those who would have prescribed both an NSAID and a gastroprotective agent.
The response rate for the survey was 28.3% and included responses from 340 physicians; 278 were included in the analysis. Most of the responders were family practice physicians who practiced in an urban setting. Approximately one third (35%) of responders were categorized as inappropriate prescribers. The physician's inability to assess the true risk of a future gastrointestinal event was the attribute most closely associated with inappropriate prescribing.
Pharmacists are in an optimal position to advocate for at-risk patients who should receive prophylaxis for NSAID-induced gastrointestinal effects as well as to identify those patients who are receiving prophylaxis without being at risk. NSAIDs are one of the most frequently prescribed classes of medications and are also available over-the-counter. Patients can have a variety of responses to the warnings about the use of this class of agents: they can be inundated with warnings such that they ignore real risks, or they can be so wary that they cannot see the benefit of these medications at all. Pharmacists can serve a valuable role not only by educating providers, but also by educating patients about the real risks associated with the use of NSAIDs.
Abstract
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Murthy SK, Kauldher S, Targownik LE
Aliment Pharmacol Ther. 2006;23:1365-1372
Clinical vignettes were mailed to physicians describing patients at low risk for gastrointestinal complications who were candidates for nonsteroidal anti-inflammatory drug (NSAID) therapy. The physicians then were asked to complete a series of questions about their beliefs regarding the gastrointestinal risks associated with NSAIDs. Physician responders were separated into 2 groups based on their responses. "Appropriate prescribers" were those physicians who said they would prescribe an NSAID alone, and "inappropriate prescribers" were those who would have prescribed both an NSAID and a gastroprotective agent.
The response rate for the survey was 28.3% and included responses from 340 physicians; 278 were included in the analysis. Most of the responders were family practice physicians who practiced in an urban setting. Approximately one third (35%) of responders were categorized as inappropriate prescribers. The physician's inability to assess the true risk of a future gastrointestinal event was the attribute most closely associated with inappropriate prescribing.
Pharmacists are in an optimal position to advocate for at-risk patients who should receive prophylaxis for NSAID-induced gastrointestinal effects as well as to identify those patients who are receiving prophylaxis without being at risk. NSAIDs are one of the most frequently prescribed classes of medications and are also available over-the-counter. Patients can have a variety of responses to the warnings about the use of this class of agents: they can be inundated with warnings such that they ignore real risks, or they can be so wary that they cannot see the benefit of these medications at all. Pharmacists can serve a valuable role not only by educating providers, but also by educating patients about the real risks associated with the use of NSAIDs.
Abstract
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