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Patients prescribed NSAIDs are 'seriously at risk'

The audit shows there is “a way to go” to ensure patients use NSAIDs “in the safest way possible”, the negotiator says

PSNC audit finds thousands of patients using NSAIDs without gastroprotection

More than a quarter of patients prescribed NSAIDs could be at risk of “serious complications”, a pharmacy audit has suggested.

Forty per cent of more than 16,000 patients on NSAIDs audited by pharmacies last year had not been co-prescribed any gastroprotection, contrary to Nice guidance, PSNC said last week. Twenty-seven per cent of patients had used NSAIDs regularly for more than two months without this protection, which could result in potentially serious health problems, the negotiator stressed.

To compile the audit, almost 1,300 pharmacies submitted two weeks-worth of information about patients prescribed NSAIDs or Cox2 inhibitors to the PharmOutcomes data collection tool.

The national NSAID audit, which was the first of its kind, showed there was still “a way to go” to ensure patients used these medications “in the safest way possible”, PSNC said.

The audit, developed by PSNC and the NHS Specialist Pharmacy Service (SPS), also found that 10 per cent of patients audited were aged over 65 but had not been prescribed medication to prevent gastric damage, despite being at “particular risk”of this complication, the negotiator said.

Pharmacies offered two thirds of patients advice on their medicines, and referred 13 per cent of those without gastroprotection to their GPs, PSNC said.

Along with the reclassification of the NSAID diclofenac to a prescription-only medicine last week due to fears of cardiac side effects (see above story), PSNC said the audit was a “reminder of the potential safety implications around NSAID use”.

Carina Livingstone, associate director of the NHS SPS’s medicines use and safety team, said the data confirmed that pharmacists were a “final safety net” for patients.

“These results clearly show the impact pharmacies can have in identifying patients at potential risk of avoidable harm: offering advice and referring [them] for safety reviews,” she added.


How do you deal with patients who are using NSAIDs unsafely?


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Disillusioned Pharmacist, Community pharmacist

Hang on what about the warning about osteoporosis with longer than 2 weeks PPI? These things cannot be taken in isolation!

N O, Pharmaceutical Adviser

While on this subject, I propose ........ Get rid of the current MUR system, introduce Condition specific MUR+ (eg. Diabetes, CVD, Asthma/COPD, NSAID etc) with a 6 monthly review instead of annual review and take the ceiling number away so that it can actually reflect numbers benefited rather than numbers filled in to finish the annual quota !! This will benefit -- greatly to patients as there won't be any cap on how many can use the service, clinically more orientated hence Pharmacists don't moan, NHS will save more by reducing wastage & un-necessary hospitalisation (specially Diabetes & Asthma/COPD) and the GPs would be more inclined/ obliged to look in to the suggestions of the Pharmacists as they have been conducted on Clinical Basis. I know I am day dreaming ......... but worth the dream :-)

London Locum, Locum pharmacist

NO you idealist you! Doing something on a clinical basis sounds fantastic but sadly not practical. Those one minute MURs for oblivious patients all count.

Leon The Apothecary, Student

Also a very easy MUR opportunity to flag.

London Locum, Locum pharmacist

Nice easy $28 for the contractor/multiple or ZERO if you're the pharmacist actually doing it.

London Locum, Locum pharmacist

Is the truth so difficult to take? lol

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