Talking to Senior Patients about NSAIDs: Change Is Likely

MARCH 15, 2017
David Cabral, 2017 PharmD Candidate, the University of Connecticut

Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the most common and accessible medications available. More than 70 million NSAID prescriptions are written annually in the United States, and approximately 30 billion doses are sold over the counter. 
 
NSAIDs are included in the Beers criteria list as potentially inappropriate for older patients. Because they are so easily obtained, patients may be unaware of their potentially hazardous side effects, including hypertension, gastrointestinal bleeds, and kidney injury. Older patients are at an increased risk of experiencing these adverse reactions because of their impaired drug metabolism, comorbidities, or low health literacy.
 
Researchers at MCHPS University published a study in the March 2017 issue of The Consultant Pharmacist that explores the effects of pharmacist counseling on NSAID use.
 
Pharmacists and pharmacy students interviewed 83 patients aged 60 and older and questioned them on their use of NSAIDs. They also collected information on their demographics and comorbidities. Patients received counseling on NSAID adverse reactions and suggestions for safer drug dosing or alternative therapy.
 
Of the 39 patients that reported using NSAIDs, 28 patients also used an interacting drug or had an interacting comorbidity. After follow-up, this number of inappropriate users dropped to 19.  Half of the patients reported changing their use of NSAIDs after receiving counseling, and more than 70% stated that they had a better understanding of NSAID risks.
 
More than half of the follow-up patients reported having a more meaningful conversation with their physician after receiving counseling, and nearly all of them stated they would recommend NSAID counseling to others.
 
Only 3 patients reported receiving pharmacist counseling on NSAID safety previously, highlighting a potential opportunity for pharmacists to make a significant clinical impact.
 
The authors concluded that health care providers should identify at-risk patients and provide NSAID education to protect the rapidly growing senior population from negative outcomes.
 
Reference
 
Woods J. Nadelson M. Sliding-scale insulin use in long-term care: an updated perspective. Consult Pharm. 2017;32(2):106-108.
 

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