Non-steroidal anti-inflammatory drug usage and requirement in elderly acute hospital admissions.

Jones AC; Berman P; Doherty M.
Br J Rheumatol, 31(1):45-8 1992 Jan.

This study evaluated the use of non-steroidal anti-inflammatory drugs (NSAIDs) and their adverse effects in a sample population of 500 elderly patients acutely admitted to the hospital. Sixty-five patients were receiving NSAIDs; of them, 56 had conditions possibly caused or worsened by the use of these drugs. Fifty-six patients were successfully taken off NSAID therapy and almost 40% of them did not require any substitute treatment, indicating high rates of unnecessary prescribing and preventable adverse reactions in this sample population.

Drug-related problems in elderly patients admitted to Tayside hospitals, methods for prevention and subsequent reassessment.

Cunningham G; Dodd TR; Grant DJ; McMurdo ME; Richards RM.
Age Ageing, 26(5):375-82 1997 Sep.

The results of this study, performed on a sample population of 1011 elderly patients admitted to the hospital over a 9-month period, show that the incidence of adverse drug reactions in this age group is 14%. Adverse drug reactions were the probable or definite cause of hospital admission in 5.3% of patients, and were related to nonsteroidal anti-inflammatory drug (NSAID)-use in 28% of cases. More than two-thirds of hospitalizations due to NSAIDs were judged to be definitively preventable.

Are non-steroidal anti-inflammatory drugs always necessary? A general practice survey.

Swift GL, Rhodes J.
Br J Clin Pract 1992 Summer;46(2):92-4.

This study, conducted on 38 randomly selected patients with osteoarthritis or musculoskeletal pain treated with non-steroidal anti-inflammatory drugs (NSAIDs), shows that in 63% of them NSAID treatment was successfully discontinued and replaced by alternative analgesics, while in 5% of them dosage was effectively reduced.

Patient awareness of the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs).

Wynne HA; Long A.
Br J Clin Pharmacol, 42(2):253-6 1996 Aug.

This study evaluated patients' awareness of the risks associated with non-steroidal anti-inflammatory drug (NSAID)-treatment in a sample population of 50 individuals who experienced acute gastrointestinal bleeding while taking NSAIDs, and 100 matched controls also on NSAID therapy but without this complication. Only 16% of cases and 41% of controls recalled having being instructed on the possibility of adverse effects; in addition, only 4% of cases and 21% of controls were informed on what to do if adverse events occurred. Reduced NSAID intake at the occurrence of epigastric pain was reported by 11% of patients who developed GI bleeding and by 67% of controls. These data indicate that the majority of patients are not informed on the possibility of experiencing severe adverse reactions from treatment with NSAIDs. It is however pivotal that patients be fully informed on the risks associated with treatment, as this information could affect their choice as to whether undergoing treatment, and, as the data collected in this study show, could potentially spare some of the morbidity and mortality from treatment-related complications by supporting more cautious use of these drugs and lower dose intake, should any warning sign occur.

Cost-conscious prescribing of nonsteroidal anti-inflammatory drugs for adults with arthritis.

A review and suggestions.
Greene JM, Winickoff RN.
Arch Intern Med 1992 Oct;152(10):1995-2002.

This study discusses the lack of justification for first line use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of painful musculoskeletal conditions, and proposes the use of acetaminophen instead of NSAIDs for the treatment of noninflammatory disorders, and of nonacetylated salicylates as safer and cheaper alternative to NSAID treatment.