Awareness among patients taking oral non-steroidal anti-inflammatory drugs as analgesics: a cross-sectional study

Abstract

Aim: Non-steroidal anti-inflammatory drugs (NSAIDs), the most used drugs for pain management, are among the most commonly prescribed drugs both in the world and in Turkey. NSAIDs have a serious side effect profile, and their inappropriate use can result in adverse outcomes, including mortality. This study aimed to determine awareness among patients who presented to a family medicine outpatient clinic who used oral NSAIDs for pain relief. Material and Method: This was a cross-sectional and descriptive study. The universe of the study consisted of patients aged ≥18 years who presented to the Ankara City Hospital Family Medicine Outpatient Clinic at the end of 2019 for any reason who used at least one type of oral NSAID for pain relief. Data were collected using a questionnaire developed by the researchers. Awareness was measured via a survey concerning knowledge and attitude, and knowledge and attitude scores were calculated for each participant. Significance was determined at a p < 0.05 level. Results: There were 210 participants. The most used NSAID was diclofenac. The most common reasons for painkiller use were headache and musculoskeletal pain. Participants had poor knowledge of the diseases associated with NSAID use, and the most well-known diseases were stomach ulcer and bleeding and kidney failure. Participants' average knowledge scores were low, and average attitude scores were relatively higher. Women had significantly higher knowledge scores than men. Knowledge and attitude scores were positively associated with education and income status. Painkiller use was positively correlated with age and negatively correlated with attitude scores. Participants with chronic diseases had lower attitude scores than those without chronic diseases. Knowledge and attitude scores were positively correlated. Conclusion: We conclude that participants lacked knowledge about the general characteristics of and risks associated with NSAIDs, widely used, over-the-counter drugs that are found in almost every home. A more cost-effective, knowledgeable, and rational approach is required for NSAID use.

Keywords

• Analgesics
• Pain Management
• Non-Steroidal Anti-Inflammatory Agents
• Rational Drug Use
• Family Medicine

Project Number

Yoktur.

References

1. Tielemans MM, van Rossum LG, Eikendal T, et al. Gastrointestinal symptoms in NSAID users in an 'average risk population': results of a large population-based study in randomly selected Dutch inhabitants. Int J Clin Pract 2014; 68: 512-9.
2. “Türki̇ye i̇laç sektörü 2017” Access URL address: http: //ieis.org.tr/ieis/tr/sektorraporu2017/#1, İlaç Endüstrisi İşverenler Sendikası (İEİS), Access Date: 11.09.2020
3. Lanza FL, Chan FK, Quigley EM; Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol 2009; 104: 728-38.
4. Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 1999; 106: 13-24.
5. Harirforoosh S, Jamali F. Renal adverse effects of nonsteroidal anti-inflammatory drugs. Expert Opin Drug Saf 2009; 8: 669-81.
6. Ardoin SP, Sundy JS. Update on nonsteriodal anti-inflammatory drugs. Curr Opin Rheumatol 2006; 18: 221-6.
7. Türkiye Cumhuriyeti Sağlık Bakanlığı, “Sağlik i̇stati̇sti̇kleri̇ yilliği,” 2016.
8. N. Yılmaz, “Ankara Atatürk Eğitim ve Araştırma Hastanesi Aile Hekimliği Polikliniklerine Başvuran Hipertansif Hastaların Kan Basıncı Regülasyon Durumları ile Ağrı Kesici Kullanım Profilleri ve Non-steroid Antiinflamatuar İlaç Yan Etki Bilgi Düzeylerinin Karşılaştırılması” phD Thesis, Department of Family Medicine, Ankara; 2018

9. Karami NA, Altebainawi AF, Alfarki SA, et al. Knowledge and attitude of analgesics use among Saudi population: A cross-sectional study. Int J Med Sci Public Health 2018; 7: 137-42.
10. H. Balabanlı, “Investigation of knowledge levels and attitudes of patients using NSAİD about those medications who applied to Ankara Training and Research Hospital Family Practice Polyclinics'' phD Thesis, Department of Family Medicine, Ankara; 2019
11. Öksüz A, Atadağ Y, Aydın A, Kaya D. The frequency of analgesic drug use and causes in 65 years old and above; A family medicine unit experience. J Surg Med 2017; 1: 12–4.
12. Ö. Hopayılmaz, “Centers in burdur province 65-85 age group conscious non-steroidal anti-inflammatory in humans determination of levels of drug use” Master Thesis, University of Burdur Mehmet Akif Ersoy, Department of Pharmacology and Toxicology, Burdur; 2018
13. Roshi D, Toçi E, Burazeri G, Schröder-Bäck P, Malaj L, Brand H. Users' Knowledge About Adverse Effects of Non-steroidal Anti-inflammatory Drugs in Tirana, Albania. Mater Sociomed 2017; 29: 138-42.
14. Karakitsiou M, Varga Z, Kriska M, Kristova V. Risk perception of NSAIDs in hospitalized patients in Greece. Bratisl Lek Listy 2017; 118: 427-30.
15. İlhan MN, Aydemir Ö, Çakır M, Aycan S. Akılcı olmayan ilaç kullanım davranışları: Ankara’da üç ilçe örneği,” Türkiye Halk Sağlığı Derg 2014: 12: 188.
16. De Bolle L, Mehuys E, Adriaens E, Remon JP, Van Bortel L, Christiaens T. Home medication cabinets and self-medication: a source of potential health threats?. Ann Pharmacother 2008; 42: 572-9.
17. Özçelikay G. Akılcı İlaç Kullanımı Üzerinde Bir Pilot Çalışma. Ankara Üniversitesi Eczac. Fakültesi Derg 2001; 30: 9–18.
18. Beggi B, Aşık Z. Evaluation of Rational Drug Use in Patients Applying to Family Medicine Outpatient Clinic. Ankara Med. J 2019: 19.
19. Önder E, Koçıa O, Öztürk S, Sabuncu Z, Soyutemiz Ö, Altıntaş H. Yunus Emre Sağlik Ocağı Bölgesi̇nde Yaşayan 18 Yaş ve Üstü Bi̇reyleri̇n Ağrı Kesi̇ci̇ Kullanımı ve Bu Konudaki̇ Bazı Bi̇lgi̇leri̇ni̇n Saptanması,” Hacettepe Toplum Hekim Bülteni , 2002; 23: 16–28.Palos GR, Mendoza TR, Cantor SB, Aday LA, Cleeland CS. Perceptions of analgesic use and side effects: what the public values in pain management. J Pain Symptom Manage 2004; 28: 460-73.
20. Paulose-Ram R, Hirsch R, Dillon C, Losonczy K, Cooper M, Ostchega Y. Prescription and non-prescription analgesic use among the US adult population: results from the third National Health and Nutrition Examination Survey (NHANES III). Pharmacoepidemiol Drug Saf 2003; 12: 315-26.
21. Ö. Türker, Status of the polypharmacy and the rational drug usage who applied to the polyclinics of the Ankara Training and Research Hospital, phD Thesis, Department of Family Medicine, Ankara; 2017