Guidelines for safe use of NSAIDs in older people ignored

July 1, 2014, University of Sydney
Nurse gives injection to woman, New Orleans, 1941. Credit: Wikipedia.

Research by the University of Sydney has found that older Australians are taking non-steroidal anti-inflammatory drugs (NSAIDs) for too long and without sufficient precautions to minimise harmful side-effects.

NSAIDs are commonly used to treat pain and inflammation associated with rheumatoid arthritis and other musculoskeletal disorders. In Australia, NSAIDs include both prescription and over-the-counter medicines, such as celecoxib (Celebrex), ibuprofen (Nurofen) and diclofenac (Voltaren).

Despite guidelines recommending the short term use of NSAIDs, the study of 1,700 older Australian men aged 70 years and older reports that patients were prescribed these drugs for five years on average.

"Prescribing doctors are not adhering to the specific guidelines for the safe use of NSAIDs in older people" said lead author of the paper Dr Danijela Gnjidic from the Faculty of Pharmacy at the University of Sydney.

"Australian and international guidelines suggest NSAIDS should be used for short-term treatment and be taken as needed. This is clearly not what is happening in reality.

"Our study found that although NSAID use was relatively low, it was more likely to be on a regular basis than an as-needed basis.

"Older people have a higher risk of developing serious complications from taking NSAIDs, so they should be used with caution.

"Use of these drugs has been linked with adverse gastrointestinal and cardiovascular effects, including ulceration and bleeding, elevated blood pressure, stroke and worsening heart failure.

"Only 25 per cent of NSAIDs users were prescribed a (PPI) to prevent or manage side-effects, despite that this should be standard.

"Our study also found that older people taking NSAIDs were more likely to take other potentially harmful interacting drugs.

"The difference between the guideline recommendations for prescribing NSAIDs and what is happening in the real world is alarming, and should be explored further. This study shines a light on a topic where little research has been done.

"Our study has highlighted the need for health practitioners and consumers to work together to determine the most effective strategies for ensuring safe and appropriate prescribing of NSAIDs for older people.

"It is important to regularly review medicines taken by to ensure they meet their treatment goals while avoiding putting patients at greater risk of harmful side effects," Dr Gnjidic said.

This research was published in PAIN journal.

Explore further: Painkillers linked to heightened irregular heartbeat risk in older adults

More information: "Non-steroidal anti-inflammatory drugs (NSAIDs) in older people: prescribing patterns according to pain prevalence and adherence to clinical guidelines." Danijela Gnjidic, Fiona M. Blyth, David G. Le Couteur, Robert G. Cumming, Andrew J. McLachlan, David J. Handelsman, Markus Seibel, Louise Waite, Vasi Naganathan. Pain. DOI: 10.1016/j.pain.2014.06.009

Related Stories

Painkillers linked to heightened irregular heartbeat risk in older adults

April 8, 2014
Current and recent use of painkillers/anti-inflammatories may be linked to a heightened risk of an irregular heartbeat (atrial fibrillation) among older adults, finds a large population study published in the online journal ...

High prevalence of NSAID prescription in those at risk of heart attack/death in primary care

June 14, 2013
New study data presented today at EULAR 2013, the Annual Congress of the European League Against Rheumatism, demonstrate a high prevalence of NSAID prescriptions in patients at risk of ischaemic heart disease (IHD).

Meta-analysis confirms common painkillers increase risk of heart problems and death but suggests size of these risks can

May 29, 2013
NSAIDs have been the cornerstone in managing pain in people with inflammatory disorders like rheumatoid arthritis, and are some of the most commonly used drugs worldwide. Earlier research has linked their use with an increased ...

Taking painkillers increases death risk, second heart attacks in survivors

September 10, 2012
Heart attack survivors who take common painkillers after a heart attack have a higher long-term risk of dying or having a second heart attack, according to a new study published in Circulation, an American Heart Association ...

NSAIDs do not increase risk of miscarriages, study reports

February 3, 2014
Women who take nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy are not at increased risk of miscarriages, confirms a new study published in CMAJ (Canadian Medical Association Journal).

Recommended for you

In most surgery patients, length of opioid prescription, number of refills spell highest risk for misuse

January 17, 2018
The possible link between physicians' opioid prescription patterns and subsequent abuse has occupied the attention of a nation in the throes of an opioid crisis looking for ways to stem what experts have dubbed an epidemic. ...

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.