Safe medication use in older people ignored
Research by the University of Sydney has found that older Australians are taking non-steroidal anti-inflammatory drugs (NSAIDs) for too long and without sufficient precautions to minimise harmful side effects.
Dr Danijela Gnjidic, lead author of the paper, says prescribing doctors are not adhering to the specific guidelines for the safe use of non-steroidal anti-inflammatory drugs in older people.
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 Dr Danijela Gnjidic, lead author of the paper.
“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.”
According to Dr Gnjidic, older people have a higher risk of developing serious complications from taking NSAIDs, therefore 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,” she said.
Only 25% of NSAIDs users were prescribed a proton pump inhibitor (PPI) to prevent or manage side effects, despite guideline recommendations that this should be standard.
The study also found 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,” Dr Gnjidic said.
“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.”
