Racial/ethnic disparities in patient-reported nonsteroidal antiinflammatory drug (NSAID) risk awareness, patient-doctor NSAID risk communication, and NSAID risk behavior.
OBJECTIVE
Nonsteroidal antiinflammatory drugs (NSAIDs) are commonly used and frequently lead to serious adverse events. Little is known about NSAID-related ethnic/racial disparities. We focused on differences in patient NSAID risk awareness, patient-doctor NSAID risk communication, and NSAID risk-avoidance behavior.


METHODS
We performed a cross-sectional analysis of survey data from the Alabama NSAID Patient Safety Study. Eligible patients were > or = 65 years old and currently taking prescription NSAIDs (Rx NSAIDS). Generalized linear latent and mixed models accounted for nesting of patients within physicians.


RESULTS
Of all 404 participants, 32% were African American and 73% were female. The mean +/- SD age was 72.8 +/- 7.5 years, and 64% reported an annual household income <$20,000. African American patients were less likely than white patients to recognize any risk associated with over-the-counter (OTC) NSAIDs (13.3% versus 29.3%; P = 0.001) and Rx NSAIDs (31.3% versus 49.6%; P = 0.001), report that their doctor discussed possible NSAID-related gastrointestinal problems (38.0% versus 52.4%; P = 0.007), and take medications to reduce ulcer risk (30.5% versus 50.2%; P = 0.001). Patients with lower income and education reported significantly less risk awareness for OTC and Rx NSAIDs. Racial/ethnic differences persisted after adjusting for multiple confounders.


CONCLUSIONS
In this community-based study of low income elderly individuals receiving NSAIDs, we identified important racial/ethnic differences in risk awareness, communication, and behavior. Additional efforts are needed to promote safe NSAID use and reduce ethnic/racial disparities.
University of Alabama at Birmingham, Birmingham, AL, USA. rfry@uab.edu
Rachel B
RB
Fry
Midge N
MN
Ray
Daniel J
DJ
Cobaugh
Norman W
NW
Weissman
Catarina I
CI
Kiefe
Richard M
RM
Shewchuk
Kenneth G
KG
Saag
Jeffrey R
JR
Curtis
Jeroan J
JJ
Allison
D001741:Black or African American / Q000193:education*; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001364:Awareness; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012216:Rheumatic Diseases / Q000188:drug therapy / Q000208:ethnology; D012307:Risk Factors; D012309:Risk-Taking; D044465:White People / Q000193:education*
D000894:Anti-Inflammatory Agents, Non-Steroidal