Pharmacist Counseling and the Use of Nonsteroidal Anti-Inflammatory Drugs by Older Adults.

ABSTRACT

OBJECTIVE: To determine the impact a medication review has on the detection and use of nonsteroidal anti-inflammatory drugs (NSAIDs) by older adults compared with non-NSAID users in regard to interacting drug classes, interacting comorbidities, and prior counseling by providers. DESIGN: Prospective, quasi-experiment without control. SETTING: Ambulatory. PATIENTS Patients 60 years of age and older who contacted the pharmacy outreach program. In total, 83 patients consented. Twenty-eight patients were eligible for three-month follow-up. INTERVENTIONS: Pharmacists and pharmacy students provided NSAID counseling. MAIN OUTCOME MEASURES: Patient-reported changes of NSAID use, change from inappropriate to appropriate use, impression of risk awareness, and further discussion with health care providers. RESULTS: NSAID use was reported by 39 (47.6%) of 83 patients. Inappropriate use was detected in 28 (71.8%) of NSAID users; of these, 18 (64.3%) were reached for post-counseling follow-up. The number of appropriate users increased to 20 (51.3%), with a concomitant reduction of inappropriate users to 19 (48.7%). Nine (50%) reported change in the use of NSAIDs, 13 (72.2%) had a better understanding of the risks associated with NSAID use, and 10 (55.6%) had a more meaningful conversation with providers. CONCLUSIONS: Older adults who use NSAIDs may be unaware of potential risks. Counseling older adults may reduce potentially inappropriate use and increase patient risk awareness. Pharmacists can improve their role in recognizing and counseling patients on NSAIDs.