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13% of high-risk OTC NSAID users faced serious adverse events
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Over-the-counter nonsteroidal anti-inflammatory drugs were used by about one in eight patients in the Netherlands who had a high risk for developing a serious adverse event, according to research presented at the annual congress of the European League Against Rheumatism in Madrid.
“[Nonsteroidal anti-inflammatory drugs] tend to be regarded by patients as harmless painkillers,” researcher Aafke Koffeman of the Department of General Practice, Erasmus Medical Center, Rotterdam, Netherlands, said in a press release. “In most cases, it is likely to be ignorance of these potential [adverse events] rather than deliberate disregard of the risks and contraindications.”
Koffeman and colleagues studied adults registered with four Dutch general practitioners. Two patient groups were selected: a random sample of adults (general population; n=120) and adult patients with a high risk for developing a serious adverse event from using a nonsteroidal anti-inflammatory drug (NSAID; high-risk population; n=265).
Electronic health records were used to determine patients’ risk profiles. Prescription guidelines were used to determine if patients were considered at high risk, including patients with a history of peptic ulcer or ulcer complications, myocardial infarction, stroke or heart failure, those aged older than 70 years, and glomerular filtration rates of less than 30 ml/L. High risk patients also met any two of the following: use of anticoagulant, aspirin, corticosteroid or selective serotonin reuptake inhibitor, aged 60 to 70 years, history of severe rheumatoid arthritis or diabetes mellitus. All patients received a questionnaire regarding over-the-counter (OTC) NSAID use.
Twenty-nine percent of the general population cohort and 13% of the high-risk cohort had used OTC NSAIDs within four weeks before study inclusion. Musculoskeletal complaints were the reason 67% of the high-risk population and 46% of the general population used OTC NSAIDs.
More than 30% of high-risk users reported taking OTC NSAIDs for more than 7 days compared with more than 20% of the general population. Nine percent of OTC NSAID users in the general population and 3% of users in the high-risk population exceeded the recommended daily maximum dose.
“These new data highlight the importance of health care professionals continuing to inform their patients of the risks of taking OTC NSAIDs,” Koffeman said. “High-risk patients with painful musculoskeletal complaints should be advised to take safer alternative painkillers.”
For more information:
Koffeman A. OP0202: Use of Over-the-Counter Nonsteroidal Anti-Inflammatory Drugs in the General Population and in Patients with a High Risk of Adverse Drug Events. Presented at: EULAR 2013; June 12-15, Madrid.