By COLLEEN CREAMER
For VerusMed
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the population of elderly independent living residents appears to be disproportionally high relative to the population as a whole, as is the subsequent risk of gastrointestinal (GI) complications due to the use of NSAIDs in that population, new research suggests.
The authors of the study pointed out that because of high rates of arthritis and “musculoskeletal complaints,” the senior population uses a large volume of both prescription and over-the-counter (OTC) NSAIDs. Further, they report that studies have shown that upper GI events occur in one out of every 20 NSAID users and in one out of every seven elderly NSAID users.
Investigators developed a 28-question survey, which assessed the use of NSAIDs, as well as the use of aspirin for cardiovascular prophylaxis, and distributed the survey to both non-NSAID-using and NSAID-using participants (n=128 total) with a mean age of 83.8 years in three independent living facilities.
In evaluating the risk for NSAID-related GI events, researchers measured risk using a six-item survey called the Standardized Calculator of Risk for Events (SCORE). The four SCORE risk levels for the use of NSAIDS were risk level 1, “not significantly increased”; risk level 2, “moderately increased”; risk level 3, “significantly increased”; and risk level 4, “substantially increased.”
Results of the study showed that 62 percent of participants reported use of prescription and/or non-prescription NSAID therapy. Additionally, 12.5 percent of participants said they used two or more NSAIDs concurrently, and 43 percent of NSAID users reported also using aspirin for cardiovascular protection.
In the prescription category, Pfizer Inc.’s Celebrex (celecoxib) and ibuprofen were the two drugs with the highest reported use. In the OTC NSAIDs group, the two drugs with the highest reported use were iburofen and aspirin.
The study revealed that the risk for GI complications related to the use of NSAIDs was “significant” or “substantial” in 88.9 percent of the group that used NSAIDs. Therapy with a GI agent was also reported by 29 percent of NSAID users (proton pump inhibitors, 24.4 percent, and H2-receptor antagonists, 4.8 percent).
“Pharmacist interventions with independent living residents receiving NSAID therapy could address important therapeutic issues, including use of two or more NSAIDs, NSAID therapy in patients at high risk for GI events and potential antagonists of aspirin’s cardioprotective effects,” the authors concluded. (Pritchett A, et al. Poster #25)
