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British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Oct 17;295(6604):962–964. doi: 10.1136/bmj.295.6604.962

Repeat prescribing of non-steroidal anti-inflammatory drugs excluding aspirin: how careful are we?

K Steele 1, K A Mills 1, A E Gilliland 1, W G Irwin 1, A Taggart 1
PMCID: PMC1248010  PMID: 3119129

Abstract

About 5% of all National Health Service prescriptions in Britain and a quarter of reports of suspected adverse reactions are accounted for by non-steroidal anti-inflammatory drugs. Their prescription was investigated in two computerised group practices serving 11850 patients. Altogether 198 patients receiving repeat prescriptions of non-steroidal anti-inflammatory drugs were identified and relevant clinical details extracted from their notes. Of these patients, 119 were over 65 years old; 172 were receiving one of six different non-steroidal anti-inflammatory drugs; and 76 were taking drugs that can interact with non-steroidal anti-inflammatory drugs. Ninety one patients had one or more medical conditions that may be aggravated by non-steroidal anti-inflammatory drugs, and 36 had experienced side effects important enough for their treatment to be changed. A questionnaire to assess opinions and knowledge of non-steroidal anti-inflammatory drugs was given to 42 general practitioners and 26 rheumatologists. Although the two groups showed a comparable knowledge of the properties and costs of non-steroidal anti-inflammatory drugs, they differed significantly in their views on the circumstances under which these drugs should be used. Clear guidelines on the prescription of these drugs would indicate when careful monitoring is essential for patients to benefit from them safely.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams D. H., Howie A. J., Michael J., McConkey B., Bacon P. A., Adu D. Non-steroidal anti-inflammatory drugs and renal failure. Lancet. 1986 Jan 11;1(8472):57–60. doi: 10.1016/s0140-6736(86)90714-2. [DOI] [PubMed] [Google Scholar]
  2. Blackshear J. L., Davidman M., Stillman M. T. Identification of risk for renal insufficiency from nonsteroidal anti-inflammatory drugs. Arch Intern Med. 1983 Jun;143(6):1130–1134. [PubMed] [Google Scholar]
  3. Brater D. C., Fox W. R., Chennavasin P. Interaction studies with bumetanide and furosemide. Effects of probenecid and of indomethacin on response to bumetanide in man. J Clin Pharmacol. 1981 Nov-Dec;21(11-12):647–653. doi: 10.1002/j.1552-4604.1981.tb05677.x. [DOI] [PubMed] [Google Scholar]
  4. Brezin J. H., Katz S. M., Schwartz A. B., Chinitz J. L. Reversible renal failure and nephrotic syndrome associated with nonsteroidal anti-inflammatory drugs. N Engl J Med. 1979 Dec 6;301(23):1271–1273. doi: 10.1056/NEJM197912063012306. [DOI] [PubMed] [Google Scholar]
  5. Clive D. M., Stoff J. S. Renal syndromes associated with nonsteroidal antiinflammatory drugs. N Engl J Med. 1984 Mar 1;310(9):563–572. doi: 10.1056/NEJM198403013100905. [DOI] [PubMed] [Google Scholar]
  6. Favre L., Glasson P., Riondel A., Vallotton M. B. Interaction of diuretics and non-steroidal anti-inflammatory drugs in man. Clin Sci (Lond) 1983 Apr;64(4):407–415. doi: 10.1042/cs0640407. [DOI] [PubMed] [Google Scholar]
  7. Fowler R. W., Arnold K. G. Non-steroidal analgesics and anti-inflammatory agents. Br Med J (Clin Res Ed) 1983 Sep 17;287(6395):835–835. doi: 10.1136/bmj.287.6395.835. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Huskisson E. C. How to choose a non-steroidal anti-inflammatory drug. Clin Rheum Dis. 1984 Aug;10(2):313–323. [PubMed] [Google Scholar]
  9. Mills E. H., Whitworth J. A., Andrews J., Kincaid-Smith P. Non-steroidal anti-inflammatory drugs and blood pressure. Aust N Z J Med. 1982 Oct;12(5):478–482. doi: 10.1111/j.1445-5994.1982.tb03826.x. [DOI] [PubMed] [Google Scholar]
  10. Somerville K., Faulkner G., Langman M. Non-steroidal anti-inflammatory drugs and bleeding peptic ulcer. Lancet. 1986 Mar 1;1(8479):462–464. doi: 10.1016/s0140-6736(86)92927-2. [DOI] [PubMed] [Google Scholar]
  11. Takavarasha L., Scott D. L., Constable T. J. A pharmacist's audit of antirheumatic drugs. Rheumatol Rehabil. 1982 Nov;21(4):201–205. doi: 10.1093/rheumatology/21.4.201. [DOI] [PubMed] [Google Scholar]
  12. Walt R., Katschinski B., Logan R., Ashley J., Langman M. Rising frequency of ulcer perforation in elderly people in the United Kingdom. Lancet. 1986 Mar 1;1(8479):489–492. doi: 10.1016/s0140-6736(86)92940-5. [DOI] [PubMed] [Google Scholar]
  13. Watkins J., Abbott E. C., Hensby C. N., Webster J., Dollery C. T. Attenuation of hypotensive effect of propranolol and thiazide diuretics by indomethacin. Br Med J. 1980 Sep 13;281(6242):702–705. doi: 10.1136/bmj.281.6242.702. [DOI] [PMC free article] [PubMed] [Google Scholar]

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