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Communicating non-steroidal anti-inflammatory drug risks: verbal counseling, written medicine information, and patients' risk awareness
Authors:Schmitt Michael R  Miller Michael J  Harrison Donald L  Farmer Kevin C  Allison Jeroan J  Cobaugh Daniel J  Saag Kenneth G
Affiliation:a VA Butler Healthcare, Butler, PA, USA
b University of Oklahoma Health Sciences Center, College of Pharmacy, Department of Pharmacy, Clinical and Administrative Sciences, Oklahoma City, OK, USA
c University of Massachusetts Medical School, Department of Quantitative Health Sciences, Worcester, MA, USA
d American Society of Health-System Pharmacists Research and Education Foundation, Bethesda, MD, USA
e University of Alabama at Birmingham Center for Education and Research on Therapeutics of Musculoskeletal Diseases, Birmingham, AL, USA
f University of Alabama at Birmingham Center for Outcomes and Effectiveness Research and Education, Birmingham, AL, USA
g University of Alabama School of Medicine, Division of General Internal Medicine, Birmingham, AL, USA
Abstract:

Objective

To assess potential associations among physician counseling, pharmacist counseling, written medicine information (WMI) and patient awareness of non-steroidal anti-inflammatory drug (NSAID) risks.

Methods

Three-hundred and eighty-two older, white and African American patients prescribed NSAIDs were surveyed regarding their NSAID risk awareness defined as an index score ranging from zero to four correctly identified risks (i.e., gastrointestinal bleeding, heart attack, hypertension, and kidney disease). Associations among NSAID risk awareness and patient-reported physician counseling, pharmacist counseling, and reading of WMI were evaluated in multivariable ordered logistic regression models and confirmed using path analysis.

Results

Physician counseling was positively associated with reading WMI (p < 0.001) and NSAID risk awareness (p < 0.001). Pharmacist counseling was not associated with reading WMI (p = 0.622) and neither pharmacist counseling (p = 0.366) nor reading WMI (p = 0.916) was associated with NSAID risk awareness.

Conclusions

Physicians play a prominent role in facilitating NSAID risk awareness whereas pharmacist counseling and WMI may have limited impact.

Practice implications

The lack of significant associations among pharmacist counseling and reading WMI with NSAID risk awareness suggests a missed opportunity to improve patient understanding. There is a need for coordinated and effective strategies to communicate risk information among physicians and pharmacists and to better integrate WMI into this process.
Keywords:Non-steroidal anti-inflammatory drugs   Patient counseling   Physicians   Pharmacists   Written medicine information   Risk communication
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