Guidelines for monitoring of NSAIDS - Who listened?

Title

Guidelines for monitoring of NSAIDS - Who listened?

Creator

Rothenberg R J; Holcomb J P

Publisher

Jcr-Journal of Clinical Rheumatology

Date

2000
2000-10

Description

The side effects of nonsteroidal anti-inflammatory drugs (NSAID) include problems involving peptic ulceration, renal function, and. liver disease. Publications have stressed the need to monitor patients for these problems and the rheumatology community across the country has echoed these concerns in continuing education activities to physicians over the years. The American College of Rheumatology (ACR) disseminated recommendations for nonsteroidal anti-inflammatory drugs (NSAID) monitoring in rheumatoid arthritis (RA) patients. We used this as an example of expert opinion for monitoring of NSAID and compared it with the frequency of monitoring by primary care physicians using NSAID for various diseases. We asked whether the rheumatology community's efforts were successful over time to enhance NSAID monitoring by primary care physicians. Physicians across the United States, using a computerized medical record, allowed data to be extracted from their medical practices. Dates of NSAID prescriptions and laboratory test monitoring for any diagnosis were analyzed. Those tests included a CBC, hepatic panel, and renal tests. The frequency of baseline tests performed within 3 months before starting a NSAID by internists was 30% compared with 6% by family practitioners in private practice and 1% in academic family practice centers before publication of the ACR guideline. After dissemination of the guidelines in 1996, the frequency of baseline testing by these groups was lower. Follow-up monitoring within 3 months of starting a NSAID was also low (24, 3, and 2% respectively) and did not improve after ACR guideline publication. Publication and dissemination of the ACR guidelines, and other efforts, did not improve rates of monitoring. The rheumatology community needs to re-evaluate the effectiveness of programs that teach safe use of rheumatologic medications by primary care physicians.

Subject

complications; drugs; guidelines; laboratory monitoring; nonsteroidal antiinflammatory drugs; Rheumatology

Format

Journal Article

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

258-265

Issue

5

Volume

6

Citation

Rothenberg R J; Holcomb J P, “Guidelines for monitoring of NSAIDS - Who listened?,” NEOMED Bibliography Database, accessed April 18, 2024, https://neomed.omeka.net/items/show/6905.