NSAIDs-associated risks in patients with rheumatological diseases: analysis of medical prescriptions

Abstract

Introduction. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in curing rheumatologic diseases. To minimize the negative impact of NSAIDs on the gastrointestinal tract (GIT), it is essential to consider the patient’s risk factors and to conduct adequate gastroprotection. The main objective of the study was to assess the knowledge of primary care physicians about NSAIDs — associated gastrointestinal lesions, and to analyze the validity of choosing NSAIDs for patients with rheumatic diseases at the outpatient stage.Materials and methods. 100 of outpatient physicians were surveyed. 100 patients with rheumatic diseases referred by general practitioners/physicians for a consultation with a rheumatologist were surveyed and their medical records were analyzed.Results: 28% of rheumatological patients had a low level of risk of complications from the gastrointestinal tract, 53% — moderate level of risk, 19% — high level, but it is not reflected in the medical records. Physicians are not aware enough about the risk factors for NSAID-associated lesions of the gastrointestinal tract. Doctors find it difficult to identify groups of moderate and low risk. In 95% of cases gastroprotective proton pump inhibitorswas conducted regardless of current indications. Rebamipidewas not assigned in any case, although it was mentioned in the survey by 4% of the respondents. Most often, patients with rheumatological pathology are prescribednimesulide (37%), Ketorolac (26%). Coxibe, amtolmetinguacylwere not prescribed by general physicians to a single patient.Conclusion: Physicians are not aware enough about the risk factors for NSAID-associated lesions of the gastrointestinal tract. NSAIDs are chosen without taking into account modern clinical recommendations.