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Upper gastrointestinal NSAID side-effects are a leading cause of potentially avoidable drug-related hospital admissions among elderly people using NSAIDs without concomitant gastro-protection. Now a study from the Netherlands suggests that pharmacists’ feedback to GPs improves non-selective NSAID prescribing – even when practice is already relatively good.

Reducing NSAID risk - pharmacist input key

Pharmacists contacted GPs and advised stopping non-selective NSAIDs or, if this was not possible, prescribing GI agents for people aged at least 60 years of age at risk for upper GI adverse events. People taking non-selective NSAIDs from other pharmacies who were not taking concomitant gastro-protective drugs acted as controls.

At baseline, only 14 per cent of people at risk of GI complications taking non-selective NSAIDs did not receive gastro-protective agents. Nevertheless, persistent NSAID users managed by the pharmacists who offered feedback were a statistically significant 7 per cent more likely to show reduced risk of upper GI complications at follow-up (either by stopping the NSAID or using gastro-protection) compared with controls receiving usual care. The likelihood of reduced risk in the pharmacist-led group was 8 per cent higher in people between 60 and 70 years of age and 5 per cent higher in those older than 70 years. (Pharmacoepidemiology and Drug Safety)