scholarly journals GPs’ views and experiences of prescribing non-steroidal anti-inflammatory drugs: a qualitative study

BJGP Open ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. bjgpopen17X100869 ◽  
Author(s):  
Janet McDonald ◽  
Lynn McBain ◽  
Anthony C Dowell ◽  
Caroline Morris
Keyword(s):  
Adverse Events ◽  
Structured Interview ◽  
Evidence Base ◽  
Mitigation Strategies ◽  
Individual Interviews ◽  
Risks And Benefits ◽  
Data Saturation ◽  
Potential Benefits ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

BackgroundNon-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed in primary care despite being a high-risk drug group causing significant adverse events, yet little is known about GPs’ perceptions of NSAID risks and benefits.AimTo explore GPs’ experiences with NSAID prescribing and views about the risks and benefits of this group of medicines.Design & settingA qualitative, inductive study in general practice.MethodIndividual interviews with 15 GPs using a semi-structured interview guide. Interviews were audiorecorded and transcribed. An inductive, thematic approach was used for analysis. Sampling continued until data saturation was achieved.ResultsThree main themes illustrate GPs’ key concerns with managing NSAID risks. The first theme was perceptions of risks and benefits of NSAIDs: GPs expressed differing attitudes towards prescribing medication generally. GPs were aware of the general risks of NSAIDs but weighed these up against specific risk factors and potential benefits for particular patients. They were most concerned about long-term use, risks for children, older people, and patients with comorbidities. The second theme was assessing and mitigating risks when prescribing NSAIDs: GPs considered gastric, cardiac, and renal risks of patients as well as drug interactions. Mitigation strategies included alternative treatment, choice and dose of NSAID, and use of gastroprotective agents. The final theme was other factors impacting on NSAID risks: particularly patient expectations and over-the-counter (OTC) availability.ConclusionNSAID prescribing is a complex balance between pragmatism and potential adverse events. Given the costs of morbidity, hospitalisation, and patient demand there is an urgent need to secure a more detailed evidence base and develop practical pathways to support safer prescribing.

scholarly journals Is there a role for cherries in the management of gout?

2019 ◽  
Vol 11 ◽  
pp. 1759720X1984701 ◽  
Author(s):  
Marcum W. Collins ◽  
Kenneth G. Saag ◽  
Jasvinder A. Singh
Keyword(s):  
Adverse Events ◽  
Novel Treatment ◽  
Lowering Therapy ◽  
Tnf Α ◽  
Potential Benefits ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Acute And Chronic Inflammation ◽  
Destructive Arthropathy ◽  
Gout Flares

Despite the availability of effective urate-lowering therapy (ULT) and anti-inflammatory drugs for the treatment of gout, there is considerable interest in novel treatment approaches. Patients with gout often have a multitude of comorbidities, leading to concern over drug–drug interactions and medication adverse events. The cherry is a small nutrient-rich fruit that has garnered a great deal of attention in recent years as a nonpharmacologic option for the treatment of a multitude of disease manifestations. Perhaps a quarter of patients with gout try cherries or cherry products to treat their gout, which have antioxidant and anti-inflammatory (IL-6, TNF-α, IL-1β, IL-8, COX-I and -II) properties, hypouricemic effects, and the ability to downregulate NFkB-mediated osteoclastogenesis. Based on these properties, cherries may reduce both the acute and chronic inflammation associated with recurrent gout flares and its chronic destructive arthropathy. In this review, we explore the potential benefits of cherries and cherry products as a nonpharmacologic option for the treatment of gout.

scholarly journals The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria

10.36469/9865 ◽  
2013 ◽  
Vol 1 (2) ◽  
pp. 184-199 ◽  
Author(s):  
Nadir Hammoumraoui ◽  
Sid Ahmed Kherraf ◽  
Joaquin Mould-Quevedo ◽  
Tarek A. Ismail
Keyword(s):  
Cost Effectiveness ◽  
Adverse Events ◽  
Proton Pump ◽  
Cost Effective ◽  
Private Clinic ◽  
Effective Treatment Option ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Background: Cyclooxygenase-2 inhibitors such as celecoxib are as effective as non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) in the treatment of osteoarthritis (OA), have fewer gastrointestinal side effects, but are more expensive. Objective: To evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib versus ns-NSAIDs, with/without proton-pump inhibitor (PPI) co-therapy, for treating OA in Algeria. Methods: The National Institute for Health and Clinical Excellence (NICE) health economic model from UK, updated with relative risks of adverse events using CONDOR trial data, was adapted for costeffectiveness analysis in OA patients aged ≥65 years. Patients could initiate treatment with celecoxib or ns-NSAIDs with/without omeprazole. Conditional probabilities were obtained from published clinical trials; effectiveness measure was quality-adjusted life years (QALYs) gained/patient. The analysis was conducted from a healthcare payer’s perspective. The average daily treatment costs and frequencies of resource use for adverse events were based on data collected in August 2011 from a private clinic located in Cheraga, Algiers, Algeria. Probabilistic sensitivity analysis (PSA) was performed to construct cost-effectiveness acceptability curves (CEACs). Results: QALYs gained/patient over a 6-month horizon were higher with celecoxib (0.368) and celecoxib+PPI (0.40) versus comparators. The lowest expected cost/patient was associated with ibuprofen (US$134.76 versus US$175.67 with celecoxib+PPI, and US$177.57 with celecoxib). Celecoxib+PPI was the most cost-effective drug treatment, with an ICER of US$584.43, versus ibuprofen. Treatment with celecoxib alone showed an ICER of US$1,530.56 versus diclofenac+PPI. These ICERs are <1 gross domestic product per capita in Algeria (US$7,500). Over 1-year, 3-year and 5-year horizons, celecoxib with/without PPI co-therapy showed higher QALYs/patient versus comparators, and decreasing ICERs. The ICER of celecoxib+PPI was lower than that of comparators over all time horizons. These findings were confirmed with CEACs generated via PSA. Conclusion: Using data from a single private clinic in Cheraga, Algiers, Algeria, and after considering new adverse event risks, we showed that celecoxib with/without PPI co therapy is more cost-effective than ns-NSAID+PPI for treating OA patients aged ≥65 years. Celecoxib+PPI remains dominant over a 5-year horizon, making it the most cost-effective treatment option for medium- and long-term use.

scholarly journals Acute Myopericarditis in a Pediatric Patient after First Dose of Pfizer BioNTech COVID - 19 Vaccination: First Case Report in the Kingdom of Bahrain

2021 ◽  
Vol 33 (4) ◽  
pp. 29-32
Author(s):  
Ghada Al Qassim ◽  
Vimalarani Arulselvam ◽  
Suad R Al Amer ◽  
Salah Al Ghanem ◽  
Neale Nicola Kalis
Keyword(s):  
Case Report ◽  
Adverse Events ◽  
Pediatric Patient ◽  
Task Force ◽  
Limited Data ◽  
First Case ◽  
National Task ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Coronavirus disease 201 9 (COVID - 1 9 ) vaccination for children over 12 years of age began on May 2021 in the kingdom of Bahrain. Very limited data is available regarding the adverse events related to COVID -19 vaccination in children. This is a case report of a 12-year-old previously healthy boy with acute myopericarditis who presented on day 5 after the first dose of Pfizer COVID - 19 vaccination. Other causes of acute myopericarditis were ruled out. He was treated with non - steroidal anti-inflammatory drugs and recovered fully. This case of vaccine-induced myocarditis was reported to the national task force of Bahrain for combating COVID - 19.

Clinical and economic implications of upper gastrointestinal adverse events in Asian rheumatological patients on long-term non-steroidal anti-inflammatory drugs

2018 ◽  
Vol 21 (5) ◽  
pp. 943-951 ◽  
Author(s):  
Lydia Say Lee Pok ◽  
Fatiha Hana Shabaruddin ◽  
Maznah Dahlui ◽  
Sargunan Sockalingam ◽  
Mohd Shahrir Mohamed Said ◽  
...  
Keyword(s):  
Adverse Events ◽  
Economic Implications ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Gastrointestinal Adverse Events ◽  
Upper Gastrointestinal

scholarly journals Nonsteroidal Anti-Inflammatory Drugs and Risk of Melanoma

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Joanne M. Jeter ◽  
Joseph D. Bonner ◽  
Timothy M. Johnson ◽  
Stephen B. Gruber
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Structured Interview ◽  
Melanoma Risk ◽  
Unadjusted Odds Ratio ◽  
Epidemiologic Evidence ◽  
Inflammatory Drugs ◽  
Chemopreventive Effect ◽  
Anti Inflammatory

Because nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit tumor growthin vitro, we investigated the association between NSAIDs and melanoma to determine if there was epidemiologic evidence of a chemopreventive effect from these medications. Three hundred twenty-seven subjects with incident melanoma and 119 melanoma-free controls completed a structured interview assessing melanoma risk factors. The unadjusted odds ratio (OR) for use of nonaspirin NSAIDs was 0.58 (95% CI 0.31–1.11), in a comparison of subjects with melanoma to controls. After adjustment for melanoma risk factors, the OR was 0.71 (95% CI 0.23–2.02). Aspirin users had an unadjusted OR of 0.85 (95% CI 0.45–1.69) and an adjusted OR of 1.45 (95% CI 0.44–4.74). In this pilot study, we found no evidence of a significant association between analgesic use and melanoma risk when potential confounders are assessed. Based on conflicting reports in the literature, meta-analysis may be appropriate.

Non-steroidal anti-inflammatory drugs and risk of lower gastrointestinal adverse events: a nationwide study in Taiwan

Gut ◽  
2011 ◽  
Vol 60 (10) ◽  
pp. 1372-1378 ◽  
Author(s):  
C.-H. Chang ◽  
J.-W. Lin ◽  
H.-C. Chen ◽  
C.-W. Kuo ◽  
W.-Y. Shau ◽  
...  
Keyword(s):  
Adverse Events ◽  
Nationwide Study ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Gastrointestinal Adverse Events
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