Raising awareness of safety issues related to commonly used medicines

Duet Health will gather data and campaign to raise awareness of the side effects (adverse drug reactions [ADRs]) associated with NSAIDs. This toxicity results in significant numbers of hospitalisations and even deaths - which are largely preventable.

NSAIDs (such as ibuprofen, naproxen and aspirin) have been estimated to be responsible for 30% of UK hospital admissions for ADRs, mainly due to gastrointestinal bleeding, heart attack, stroke, and renal damage.¹

Three of the four Trustees of Duet Health Foundation have been impacted by NSAID ADRs.

• Julie's father died abruptly one night from a sudden acute gastrointestinal haemorrhage associated with chronic NSAID use.
• Mike, who is medically qualified, was hospitalised for the same reason, despite being well aware of the risks. Mike haemorrhaged and collapsed in the middle of the night and would probably have died if Julie had not been at home to call an ambulance.
• Another of our Trustees had her father hospitalised with a gastrointestinal haemorrhage associated with NSAID use.

Over 20 years ago a number of academic groups gathered to address this issue. In 2004, a scientific publication¹ reported data which concluded that preventable ADRs were responsible for 10% of hospital admissions in older people - at a cost to the UK NHS of around £800 million every year. Another publication, 12 years later in 2016 stated that deaths from ADRs due to NSAIDs remain very high: more deaths than from road traffic accidents and twice as many deaths as from asthma or cervical cancer.²

Despite the compelling data published, little has changed with respect to awareness of the potential dangers of NSAIDs. The information provided with these drugs (patient leaflets) notes the potential dangers, and recommends concomitant use of drugs which protect the gut, such as proton-pump inhibitors (eg omeprazole).

Certain NSAIDs (notably ibuprofen) are readily available without prescription in pharmacies and supermarkets, and therefore patient education should form an essential part of any risk-reduction strategy.

Currently easily available around the world, use of this class of drugs needs to be made subject to tighter safety provisions. Patients, pharmacists and even doctors need to be made more aware of recommended precautions, and to act upon them.

¹ Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004;329(7456):15–19.

² Abigail Davis & John Robson. The dangers of NSAIDs: look both ways. J Gen Practice. 2016 Apr;66(645):172–173.