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Article type: Research Article
Authors: Hamilton, Kevina; * | Davis, Christinea | Falk, Jamiea | Singer, Alexb | Bugden, Shawna
Affiliations: [a] College of Pharmacy, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada | [b] College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Correspondence: [*] Address for correspondence: Kevin Hamilton, College of Pharmacy, Faculty of Health Sciences, University of Manitoba, 750 McDermot Avenue, Winnipeg, Manitoba R3E 0T5, Canada. Tel.: +1 204 272 3140; hamilt23@myumanitoba.ca
Abstract: BACKGROUND:Complications associated with the use of NSAIDs, antiplatelet agents, and anticoagulants are among the top causes of preventable drug-related ER visits, hospitalizations and death. Although over-the-counter (OTC) NSAIDs and ASA also contribute to this preventable risk, it is unclear how well these medications are documented in primary care records. METHODS:A retrospective electronic and paper chart review was conducted to evaluate the prevalence of 13 evidence-based high-risk prescriptions and the contribution of OTC NSAIDs and ASA to these potentially inappropriate prescriptions (PIPs). RESULTS:Of the 148 patients included in the review, ASA was taken by 117 patients (79%) while OTC NSAIDs were taken by 36 (24%). OTC NSAIDs were never documented within the “medication” section of the electronic record, whereas ASA was documented in 65 (56%) cases. Eighty percent (118/148) taking either OTC NSAIDs or ASA were identified as having at least one PIP. CONCLUSION:OTC NSAIDs and ASA are widely available and are commonly taken without the knowledge of the prescriber. These medications contribute to the overall risk of bleeding. Review and documentation of OTC NSAIDs and ASA use should be part of all relevant patient encounters when prescribing NSAIDs, antiplatelets and anticoagulants.
Keywords: Patient safety, non-prescription drugs, primary care, hemorrhage, non-steroidal anti-inflammatory agents
DOI: 10.3233/JRS-150662
Journal: International Journal of Risk & Safety in Medicine, vol. 27, no. 4, pp. 191-199, 2015
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