Analysis of non-steroidal anti-inflammatory drug use in hospitalized patients and perception of their risk

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) belong to the most widely prescribed and used pharmacological agents worldwide. Data gathered in the last decade show increased incidence of thrombotic events during NSAID administration. Analysis of NSAID usage and assessment of risk for development of cardiovascular adverse effects is needed for improving patient safety. For limiting the impact of adverse effects on the health of patients, NSAID users should be informed about the possible adverse effects and their symptoms to ensure early detection and treatment discontinuation. In the presented study, we retrospectively analyzed the administration of NSAIDs in a group of patients (n=428) in need of analgesic treatment hospitalized at a department of internal medicine. Factors increasing the risk for cardiovascular adverse effects were also investigated. A separate questionnaire study was conducted to gather information concerning the knowledge of hospitalized NSAID users (n=251) about adverse effects of the medication used. For purpose of comparison, we conducted a similar study in a group of 234 random respondents from a shopping center. Data were evaluated using descriptive statistics, Student′s t-test and chi-squared test. Our results suggest that the majority of patients treated with NSAIDs have factors indicating increased risk of development of adverse effects, most commonly arterial hypertension (58.2% of patients). The results of our questionnaire study show limited knowledge of NSAID users about the risk of the therapy. Nearly half of the respondents were unaware of any adverse effects. We consider as alarming that only a limited number of respondents were informed by their physician or pharmacist about the possible risks of treatment. In conclusion, we found that hospitalized NSAID users often have a history of diseases predisposing to the development of cardiovascular adverse effects of NSAIDs. Despite this, their knowledge about the risk of treatment is insufficient.

The effect of COX-2-selective meloxicam on the myocardial, vascular and renal risks: a systematic review

“…We found seven studies (Biere-Rafi et al 2011;Chang et al 2010;Layton et al 2003a, b;Mangoni et al 2010b;Singh et al 2004;Varga et al 2013) that reported the effect of meloxicam exposure of any duration on the vascular system. Meloxicam was found to exhibit an elevated OR 0 (Table 3).…”

“…We found 13 eligible studies with information on the concomitant ASA (Biere-Rafi et al 2011;Chang et al 2010;Garcia Rodriguez et al 2008;Huerta et al 2005;Lafrance and Miller 2012;Lapeyre-Mestre et al 2013;Layton et al 2003a, b;Mangoni et al 2010a, b;Schneider et al 2006;van Staa et al 2008;Varga et al 2013) (Table 4). In general, the use of ASA resulted in the widening of the 95 % CI around the calculated composite CV/renal risk estimates.…”

“…They were combined to calculate the risk estimates (OR 0 ). All of the 19 studies (Arvind et al 2004;Biere-Rafi et al 2011;Chang et al 2010;Garcia Rodriguez et al 2008;Hosie et al 1996;Huerta et al 2005;Jick 2000;Lafrance and Miller 2012;Lapeyre-Mestre et al 2013;Layton et al 2003a, b;Mangoni et al 2010a, b;Schneider et al 2006;Shi et al 2004;Singh et al 2004;van Staa et al 2008;Varga et al 2013;Winkelmayer et al 2008) included in our review were adjusted for common variables such as age, sex, comorbidities and concomitant medication, other variables were also recorded here as study characteristics (Tables 1 and 2).…”

Practices of healthcare professionals in communicating with nonsteroidal anti-inflammatory drug users in Thailand: a qualitative study

“…Explaining the need to avoid duplicating NSAIDs was mentioned by only two interviewees, despite the potentially dangerous combination of prescription and non‐prescription NSAIDs being widespread . Few interviewees referred to the need to avoid NSAIDs or use them short term in older people or to exercise caution in patients with risk factors or concomitant drug use which could increase their chances of adverse events . The potential for acute effects on the kidney was only discussed in long‐term users.…”

“…[26] Few interviewees referred to the need to avoid NSAIDs or use them short term in older people or to exercise caution in patients with risk factors or concomitant drug use which could increase their chances of adverse events. [3,4,12,13,20,[29][30][31] The potential for acute effects on the kidney [7] was only discussed in long-term users.…”