A Cohort Study of NSAID Use
Nonsteroidal anti-inflammatory drugs (NSAIDs) constitute one of the most widely used classes of agents in primary care; more than 70 million prescriptions for NSAIDs are filled in the U.S. each year. Some investigators have estimated that 5% to 10% of the adults in the U.S. (approximately 15 to 25 million people) use NSAIDs regularly. More than 30 billion over-the-counter (OTC) NSAID tablets are sold annually in the U.S.
The widespread use of these products is often accompanied by significant adverse events, primarily of the gastrointestinal (GI) tract. In general, 10% to 20% of patients reportedly have dyspepsia while taking NSAIDs, although the true prevalence may be as high as 50%. More serious GI complications requiring hospitalization for upper GI bleeding are estimated at about 1% to 4% per year for patients taking NSAIDs.
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Results. The rates for those who continued NSAID therapy at two and six weeks were 84% and 76% for new users, 76% and 90% for changed users, and 95% and 91% for renewal users. Reasons for discontinuation at two weeks (n = 35) included (1) resolution of symptoms (17%), (2) cost or insurance issues (22%), (3) lack of effectiveness (22%), and (4) side effects (11%). At six weeks, the over the long term.
In primary care, NSAIDs are prescribed for a variety of chronic and acute conditions. To understand more about patient adherence to their NSAID regimens and their management of NSAID-induced GI symptoms, we undertook a prospective observational study of NSAID users with two objectives:
1. to characterize NSAID use and discontinuation in a cohort of primary care patients taking prescription NSAIDs
2. to characterize patterns of self-reported GI symptoms in patients taking prescribed NSAIDs and the patients’ management of these GI symptoms