Blower, A.L.; Woolf, A.D.; Amin, N.; Carr, A.J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA82
Academic Journal
Background: In the UK, up to 2000 NSAID users a year die from gastrointestinal (Gl) side effects. Little is known about the perceptions of risk and benefit associated with NSAID management of musculoskeletal pain (MP) in primary care. The Arthritis Action Group (AAG) survey was undertaken to increase understanding of the management of MP in 8 European countries. Data from UK GPs and patients are presented here. Methods: A telephone survey was conducted with 1483 doctors and 5803 chronic pain sufferers in 8 European countries. In the UK, 200 GPs and 798 MP sufferers were surveyed. All doctors and patients were randomly selected. The survey was based on a structured questionnaire that asked about health status (SF-12), usual management of MP, risks and benefits of treatment and beliefs about treatment. Results: Arthritis is the most common cause of MP. In first line management of MP, 61% of GPs use analgesia alone and 35% use NSAIDs alone. Cox-2 NSAIDs are used by 2% of GPs. 26% of patients taking prescription NSAIDs supplement with OTC medication. Most GPs (85%) are concerned about NSAID related side effects and routinely screen patients for some known risk factors but only tell patients about the most common side effects (64%). Most patients who are taking NSAIDs (71%) are unconcerned about side effects and only 51% are aware of any side effects of NSAIDs. However, among those who change medications, 42% do so because of Gl side effects. Patients' perceptions of their risk of serious Gl side effects is poor: 44% of patients who are at increased/critical risk of side effects perceive their risk as moderate or high. GPs and patients believe that the side effects of NSAIDs can be worse than the condition and few believe that they are safe from side effects if they take NSAIDs as prescribed. Patients are concerned about tolerance and addiction to NSAIDs. Conclusions: Many patients remain unaware of their personal risk, despite general concerns about NSAIDs. They...


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