What do patients in rheumatologic care know about the risks of NSAIDs?
OBJECTIVE
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, but have potentially serious adverse effects. We investigated the knowledge of patients with inflammatory arthritis with regards to risks associated with the combination of prescribed and over-the-counter (OTC) NSAIDs, of differences in side effects between acetaminophen and NSAIDs, and from which sources patients received information about side effects.


METHODS
Data from 170 questionnaires provided to consecutive patients with inflammatory arthritis at a rheumatologic outpatient clinic were collected through questionnaires (response rate 75%).


RESULTS
Eighty-seven percent of patients had taken prescribed NSAIDs or OTC analgesics during the previous 2 weeks, 36% being NSAIDs, and 36% used analgesics regularly. Fifty-four percent would increase the dose of drugs in a bad period, and they were more likely to over-use the OTC drugs than the prescribed drugs (P = 0.002, Mann-Whitney). Factors recognized to increase the risk of side effects were: higher dose (81% of patients), long-term treatment (68%), previous side effects (57%), combination of NSAIDs (49%), and old age (31%). Twenty-three percent assumed that acetaminophen increased the risk of side effects. Information was obtained from package inserts (84%), the rheumatologist (80%), and the general practitioner (50%). They had greatest confidence in the rheumatologist, package leaflets, and the general practitioner.


CONCLUSIONS
Incomplete knowledge and misconceptions of some patients suggests that more information on risk factors and side effects to NSAID treatment is needed to improve patient safety. This is especially true about the combination of prescribed and OTC drugs.
Ornbjerg
Lykke Midtbøll
LM
Department of Rheumatology, Copenhagen University Hospital at Hvidovre, Denmark. lykke@oernbjerg.dk
Andersen
Henning B
HB
Kryger
Peter
P
Cleal
Bryan
B
Hetland
Merete Lund
ML
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015331:Cohort Studies; D003718:Denmark; D004359:Drug Therapy, Combination; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use; D010003:Osteoarthritis / Q000188:drug therapy*; D010044:Outpatient Clinics, Hospital; D012648:Self Care; D012651:Self Medication; D011795:Surveys and Questionnaires
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs