Patient-reported adverse drug outcomes, from use of NSAIDs for chronic pain: a cross-sectional study in North India

BackgroundNon-Steroidal Anti-inflammatory Drugs (NSAIDs) are commonly used to relieve pain and inflammation and are available over the counter in India. Despite their known adverse drug events (ADEs), formal reporting and patient awareness remain limited. This study aimed to evaluate the knowledge, attitude, and practices (KAP) of NSAIDs users, along with associated risks and self-reported ADEs, pivotal to developing strategies to mitigate the situation. MethodsA cross-sectional study was conducted at a primary care facility in Haridwar, Uttarakhand, India. A structured questionnaire assessed KAP, risk factors, and ADE in 201 participants aged 18 to 75 years with continuous or intermittent NSAID use for [≥]3 months for chronic pain. Resultsstudy outcomes revealed that 47% of subjects did not have proper knowledge of NSAIDS, 66% nursed a negative attitude, 55% were noncompliant to prescription, 63.20% were at risk for complications, and 66.66% developed ADEs. The data revealed that 68% of the study participants wanted to discontinue NSAIDs, whereas 58% expressed firm faith in the alternative and complementary systems for pain management. Conclusion and relevanceThe awareness about NSAID complications in the study participants was found to be limited in this specific geographical area. Most participants suffered from adverse drug events, were at risk, or required education. A record of participants showed dissatisfaction with NSAIDs, perhaps for higher cost, ineffectiveness, and concerns for safety. Maximum participants desired other treatment approaches with fewer or no side effects. Our study recommends a thorough review of existing guidelines on NSAID usage.