title: High risk use of OTC NSAIDs and ASA in family medicine: A retrospective chart review.
abstract: BACKGROUND
  Complications associated with the use of NSAIDs, antiplatelet agents, and anticoagulants are among the top causes of preventable drug-related ER visits, hospitalizations and death. Although over-the-counter (OTC) NSAIDs and ASA also contribute to this preventable risk, it is unclear how well these medications are documented in primary care records.
  
  
  METHODS
  A retrospective electronic and paper chart review was conducted to evaluate the prevalence of 13 evidence-based high-risk prescriptions and the contribution of OTC NSAIDs and ASA to these potentially inappropriate prescriptions (PIPs).
  
  
  RESULTS
  Of the 148 patients included in the review, ASA was taken by 117 patients (79%) while OTC NSAIDs were taken by 36 (24%). OTC NSAIDs were never documented within the "medication" section of the electronic record, whereas ASA was documented in 65 (56%) cases. Eighty percent (118/148) taking either OTC NSAIDs or ASA were identified as having at least one PIP.
  
  
  CONCLUSIONS
  OTC NSAIDs and ASA are widely available and are commonly taken without the knowledge of the prescriber. These medications contribute to the overall risk of bleeding. Review and documentation of OTC NSAIDs and ASA use should be part of all relevant patient encounters when prescribing NSAIDs, antiplatelets and anticoagulants.
authors.affiliation: College of Pharmacy, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Hamilton
authors.affiliation: College of Pharmacy, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Davis
authors.affiliation: College of Pharmacy, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jamie
authors.initials: J
authors.lastname: Falk
authors.affiliation: College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Singer
authors.affiliation: College of Pharmacy, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Shawn
authors.initials: S
authors.lastname: Bugden
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D000980:Antiplatyhelmintic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000075202:Contraindications; D004282:Documentation / Q000592:standards / Q000706:statistics & numerical data; D004347:Drug Interactions / Q000502:physiology*; D057286:Electronic Health Records / Q000592:standards* / Q000706:statistics & numerical data; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D000980:Antiplatyhelmintic Agents; D004366:Nonprescription Drugs
keywords: Patient safety; hemorrhage; non-prescription drugs; non-steroidal anti-inflammatory agents; primary care