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 Sydney Faculty of Pharmacy.
“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 proton pump inhibitor (PPI) to prevent or manage side-effects, despite guideline recommendations 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 older people to ensure they meet their treatment goals while avoiding putting patients at greater risk of harmful side effects,” Dr Gnjidic said.
About the University of Sydney Faculty of PharmacySydney Pharmacy’s internationally renowned researchers are experts in a broad spectrum of pharmaceutical and clinical sciences, including the design, synthesis, testing and mechanism of action of drugs, studies on advanced drug delivery, investigation of the fate of drugs in humans including pharmacogenomics and other aspects of drug disposition, and research on the clinical and sociological aspects of pharmacy and health services research.
Bachelor of Pharmacy Program at the University of SydneyThe Bachelor of Pharmacy requires four years of full-time study. There are two semesters and one entry period per year. Major topics studied include chemical, physical, pharmaceutical and pharmacological properties of medicines and the application of these in the practice of pharmacy.
Program: Bachelor of Pharmacy (BPharm)
Location: Sydney, New South Wales
Semester intake: February
Duration: 4 years
Application deadline: September 30, 2014