Physician and patient knowledge of NSAID digestive complication risks

UNLABELLED: REQUIREMENT: Information given to the patient is a topic which is especially of current interest, and which has been taken into account in the recent law of March 4, 2002 on patient's rights. But what about non-steroidal anti-inflammatory agents, that is, one of the most widely prescribed classes of medicinal products worldwide and which induce the highest number of sometimes fatal adverse effects (adverse drug reactions)? FREQUENT MISREADING: The aim of this update is thus to review once again the rare studies published on this topic, a review necessary prior to the formulation of recommendations regarding information to be given to the patient before prescribing him/her an NSAIDs. A review of the literature illustrates the common misunderstanding that patients have (nearly 1/4 to 1/2) regarding the potential serious gastro-intestinal adverse effects of NSAIDs. RECOMMENDATIONS: We propose that the subjects at the very least, be informed first of the risk of dyspepsia, which is the most common side-effect but usually not predictive of a serious adverse effect; then we would point out the risk of gastro-duodenal ulcer whose complications certainly are rare but can be fatal; and lastly the existence of prophylactic strategies, including the recognition of main risk factors and some medical options, such as use of synthetic prostaglandins, proton pump inhibitors or the preferential use of coxibs.