Patients Don't Know A Lot about Commonly Used NSAIDs

A new survey of adults in the U.S. revealed that there is a lack of understanding about non-steroidal anti-inflammatory drugs (NSAIDs) in this country, despite the fact that these medications are very commonly used to manage pain and inflammation. As healthcare providers, we have a responsibility to better educate our patients about the risks and benefits of NSAIDs, as well as safe and effective ways to use them, because although they can be powerful tools in pain management, NSAIDs do carry the risk of potentially serious cardiovascular, renal and gastrointestinal side effects, according to different medical research efforts.

The aforementioned, “Understanding America’s Pain” survey, an online survey of 1,056 adults, was designed to gain a deeper understanding of the types of pain Americans are experiencing, how they are treating their pain, and their knowledge and understanding regarding commonly used NSAIDs. The survey showed that pain affects a majority of people in this country:

• Nearly 8 in 10 (77 percent) Americans surveyed have experienced at least one form of pain, whether from general pain, chronic pain, or pain as a result of aging, surgery or injury.

• Forty-three percent of Americans have experienced some form of pain weekly or more.

• Only 3 in 10 (31 percent) who experience pain feel that their pain is completely controlled.

Survey respondents also reported confusion about NSAIDs, which is surprising given the fact that in 2014, 123 million prescriptions were filled for NSAIDs in the United States, according to an audit from IMS Health. Moreover, one-third of the general population have used over-the-counter NSAIDs, according to a survey from the National Institutes of Health. The survey also revealed:

• Nearly half of those surveyed (47 percent) said they do not know what NSAIDs are.

• Among those who said they knew what NSAIDs were, many did not correctly identify common NSAID containing medications including: Excedrin (78 percent), Advil (55 percent), Aleve (54 percent), naproxen (54 percent), and ibuprofen (42 percent).

• Only half (48 percent) of medication users said they are very confident that the medications they take are the safest and most effective for their pain symptoms.

The risk of serious cardiovascular, gastrointestinal, and renal adverse events associated with NSAIDs are dose-related and can occur in as little as one week following initial dosage, according to multiple medical research efforts. We must educate patients that per FDA recommendations, both OTC and prescription NSAIDs should be taken at the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. Less than a third (27 percent) of those surveyed stated that they were aware of this guidance.

Communication between healthcare professionals and patients is key. About one in three people (34 percent) surveyed who have pain admit that they typically ignore it and 58 percent do not discuss how to manage pain with their doctor. Therefore, as healthcare professionals, it is our responsibility to ask questions to determine which medications patients are taking and how often, explain that there are many options available to manage pain, and reinforce the importance of taking NSAIDs at the lowest effective dosage for the shortest duration of time.

Dr. Anita Gupta is a Board Certified Anesthesiologist, Pain Specialist, Pharmacist and Author. She is currently Vice Chair, Associate Professor and Director at Drexel College of Medicine in the Division of Pain Medicine in the Department of Anesthesiology in Philadelphia, PA and Co-Chair of the ASA Committed on Prescription Opioid Abuse and a member of the of the FDA Anesthetic and Analgesic Committee.

Dr. Gupta was not compensated by any company for her opinions in this article.