Audit highlights problem of patients taking NSAIDs without gastroprotection

Many patients taking non-steroidal anti-inflammatory drugs (NSAIDs) are not co-prescribed gastroprotective agents, potentially putting them at risk of gastrointestinal (GI) complications, an audit of community pharmacies in England has found.

Some 72.5% of prescriptions met the audit standard that patients regularly prescribed an oral NSAID or cyclooxygenase-2 inhibitor for more than two months should be co-prescribed gastroprotection. Out of the 16,366 patients taking NSAIDs whose prescriptions were reviewed as part of the audit, 2,838 were left at risk of avoidable harm.

The authors of the analysis, from the NHS Specialist Pharmacy Service medicines use and safety team, describe the proportion of patients meeting the audit standard as “unacceptably low” and call for action to increase the figure to at least 90%. They acknowledge that 100% may not be attainable because some people may be unable or unwilling to take additional medicines.

The audit, which involved 1,278 community pharmacies, showed that pharmacies offered advice to 66% of patients and referred 14% to their GPs. Nearly all referrals involved concerns about GI safety.

“We still have a way to go to ensure that all patients on NSAIDs are using their medicines in the safest way possible,” says Alastair Buxton, head of NHS services at the Pharmaceutical Services Negotiating Committee (PSNC), which co-developed the audit. “This presents a big opportunity for community pharmacy.”

The PSNC says the NSAID audit is the first of its kind to be conducted on a national scale and was completed by pharmacies representing 87% of clinical commissioning groups. 

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Citation
The Pharmaceutical Journal, PJ, 31 January 2015, Vol 294, No 7847;294(7847):DOI:10.1211/PJ.2015.20067640