American Journal of Health Research

| Peer-Reviewed |

Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders

Received: 25 June 2014    Accepted: 10 July 2014    Published: 20 July 2014
Views:       Downloads:

Share This Article

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are of choice for acute pain management in musculoskeletal disorders (MSDs) but they are not without side effects. The primary aim of this study was to investigate user’s experience of side effects of oral NSAIDs among patients with MSDs. Multi-stage sampling technique was used to select 296 patients with MSDs from physiotherapy out-patient clinics of five selected hospitals. A structured and close ended questionnaire was administered to investigate the side effects experienced by respondents. Descriptive statistics (mean, standard deviation, frequency and percentages) and Chi-square were used to compare the mean percentage difference in the knowledge of NSAIDs and their side effects. Only 15% of the respondents were able to recognize the listed side effects. A significant number of the respondents (58.7%) were not informed of the side effects of the NSAIDs at the time of prescription (Ӽ2 = 8.82, p = 0.003). About 33.4% and 31% of respondents identified dizziness and abdominal pain respectively as side effects. Sixty two (22.3%) respondents had experienced dizziness while 15.9% experienced abdominal pains. Diclofenac was the most frequently prescribed NSAID (153 [51.7%]). Only 2.0% and 2.7% of respondents were aware of phonophoresis and iontophoresis respectively as alternative means of administering NSAIDs where applicable. The Chi-square test revealed that the number of respondents that preferred alternative means of administration (where applicable) was significantly higher than those who preferred the oral routes (x2 = 74.5, p = 0.001). We concluded that this sample of Nigerian patients was not informed of the side effects of NSAIDs by the prescribers. Dizziness and abdominal pains were the most experienced side effects. The role of alternative methods to administer NSAIDs need to be made available to patients where applicable to increase their health care choices.

DOI 10.11648/j.ajhr.20140204.11
Published in American Journal of Health Research (Volume 2, Issue 4, July 2014)
Page(s) 106-112
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Side Effects, Non-Steroidal Anti-Inflammatory Drugs, Patient’s Experience, Musculoskeletal Disorders

References
[1] Middlesworth Mark (2013). Definition of musculoskeletal disorder; ergonomic plus 1.765.384.4499.
[2] Annika, V. Nikita, J. Corrina, L. Markus, B. Konstantin, S. Jurgen, B. Annette, B. (2012). Differences between patients with chronic widespread pain and local chronic local pain in primary care- a comparative cross-sectional analysis. BMC Musculoskeletal Disorders 14: 351.
[3] Ekpenyong, C. E1, Udokang, N.E1, Akpan, E.E, Samson. (2012).Double Burden, Non-Communicable Diseases And Risk Factors Evaluation In Sub-Saharan Africa: The Nigerian Experience. European Journal of Sustainable Development; 1, 2, 249-270.
[4] Adegbehingbe O.O., Fatusi A.O., Adegbenro C.A., Adeitan O.O., Abass G.O., Akintunde A.O.(2009). January Musculoskeletal disorders: Epidemiology and treatment seeking behavior of secondary school students in a Nigerian community. Indian J community med.; 34(1): 52-56.
[5] Schnitzer TJ, Ferraro A, Hunsche E. (2004). A comprehensive review of clinical trials on the efficacy and safety of drugs for the treatment of low back pain. J Pain Symptom Manage; 28:72–95.
[6] Ekman EF, Koman LA. (2005). Acute pain following musculoskeletal injuries and orthopaedic surgery:mechanisms and management. Instr Course Lect; 54:21–33.
[7] Hickey RF (1982). Chronic low back pain: a comparison of diflunisal with paracetamol. NZ Med J; 95:312–4.
[8] Videman T, Osterman K. (1984). Double-blind parallel study of piroxicam versus indomethacin in the treatment of low back pain. Ann Clin Res; 16:156–60.
[9] Berry H,Bloom B, Hamilton, EB. (1982). Naproxen sodium, diflunisal, and placebo in the treatment of chronic back pain. Ann Rheum Dis; 41:129–32.
[10] Peloso P, Gross A, Haines T. (2005). Medicinal and injection therapies for mechanical neck disorders.The Cervical Overview Group. Cochrane Database Syst Rev; 2: CD000319.
[11] Brunton L, Lazo J, Parker K (2006). Goodman & Gilman’s the pharmacological basis of therapeutics.11th ed. New York: McGraw-Hill Companies.
[12] Vane JR, Botting RM. (2003). The mechanism of action of aspirin.Thromb Res; 110: 255–8.
[13] Weir MR. (2002). Renal effects of non - selective NSAIDs and coxibs Cleve. Clin J Med; 69(Suppl 1):SI53–8.
[14] Gollapudi RR, Teirstein PS (2004). Aspirin sensitivity: implications for patients with coronary artery disease. JAMA; 292:3017–23.
[15] Jenkins C, Costello J, Hodge L (2004). Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice. BMJ; 328:434–6.
[16] Russell R I (2001). Non-steroidal anti-inflammatory drugs and gastrointestinal damage—problems and solutions Postgrad Med J 2001;77:82–88
[17] Goldstein JL,Silverstein FE, Faich G (2000). Gastrointestinal toxicity with celecoxibvsnonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. The class study: a randomized controlled trial. JAMA; 284: 1247–55.
[18] Rostom A, Dube C, Wells G (2002). Prevention of NSAID - induced gastroduodenal ulcers. Cochrane Database Syst Rev; 4: CD002296.
[19] Brun, J.; Jones, R (2001), Nonsteroidal Anti-Inflammatory Drug-Associated Dyspepsia: the Scale of the Problem. Am. J. Med.110, 12S-13S.
[20] Kearney, P. M.; Baigent, C.; Godwin, J.; Halls, H.; Emberson, J. R.; Patrono, C (2006). Do Selective Cyclo-Oxygenase-2 Inhibitors and Traditional Non-Steroidal Anti-Inflammatory Drugs Increase the Risk of Atherothrombosis? Meta-Analysis of Randomised Trials. BMJ 332, 1302-1308.
[21] Vonkeman, H. E.; Brouwers, J. R.; van de Laar, M. A. (2006). Understanding the NSAID Related Risk of Vascular Events. BMJ, 332, 895-898.
[22] KrotzF, Schiele TM, Klauss V (2005). Selective COX-2 inhibitors and risk of myocardial infarction. J Vasc Res; 42 :312–24.
[23] Brater DC, Harris C, Redfern JS (2001). Renal effects of COX-2-selective inhibitors. Am J. Nephrol; 21:1–15.
[24] Emanuel, E J & Emanuel, L L. (1992) Four models of the physician-patient relationship. Journal of the American Medical Association. 267(16), 2221-6.
[25] Charles C, Gafni A & Whelan T. (1997) Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Social Science and Medicine 44(5), 681-692.
[26] Charles C, Gafni A, & Whelan T. (1999) Decision-making in the physician-patient encounter:revisiting the shared decision-making model. Social Science and Medicine 49, 651-661.
[27] Department of Health. (2001). The Expert Patient: a new approach to chronic disease management in the 21st century. London: Department of Health.
[28] Wanless D. (2002). Securing our future health: taking a long term view. London: HM Treasury
[29] Donaldson L. (2003). Expert patients usher in a new era of opportunity for the NHS. BMJ; 326:279–80. PMC free article. PubMed
[30] De Vries T.P.G.M., Henning R.H., Hogerzeil H.V., Fresle D.A. (1993). Guide to good prescribing; WHO/DAP/94.11.
[31] Popovich NG. Ambulatory patient care. In: Gennaro AR, ed. (1985). Remington’s pharmaceutical sciences, 17th ed. Pennsylvania: Mack Publishing Company, 1681-701.
[32] Mathers Nigel, Nick Fox,Amanda Hunn (2009) Surveys and Questionnaires. The NIHR Research Design Service for Yorkshire & the Humber. www.rds-eastmidlands.nihr.ac.uk
[33] García de Yébenes Prous M. Jesús, a,* Francisco Rodríguez Salvanés, b and Loreto Carmona Ortells (2009). Validation of questionnaires. Reumatol Clin. 2009;5(4):171-177.
[34] Wahinuddin Sulaiman, Ong Ping Seung, Rosli Ismail.Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia. Oman Medical Journal (2012) Vol. 27, No. 6: 505-508
[35] Brown JB, Stewart MA, McCracken E, et al. The patient-centred clinical method, 2: definition and application. FamPract. 1986;3:75–79.
[36] Wynne HA, Long A (1996). Patient awareness of the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) Br J Clin Pharmacol.; 42:253–256. [PMC free article] [PubMed]
[37] McMahon T, Clark C.M, Bailie G R: Who provides patients with drug information? Br Med J (Clin Res Ed); 294(6568): 355-356
[38] Yilmaz H, Gürel S, Ozdemir O (2005). The use and safety profile of non-steroidal antiinflammatory drugs among Turkish patients with osteoarthritis.Turk J Gastroenterol. Sep;16(3):138
[39] Cottrell N, Emmerton L, DenaroC (2007) Heart failure patients' awareness and perceptions of the risk of using NSAIDs: a pilot study.ClinTher. Apr; 29 (4):717-9.
[40] Albsoul-Younes AM, Jabateh SK, Abdel-Hafiz SM, Al-Safi SA (. 2004). Awareness and frequency of potential side effects on nonsteroidal anti-inflammatory drugs among the Jordanian patient population. Saudi Med J. Jul; 25(7):907-11.
[41] Nair Bindu and Taylor Regina (2010). A Review of Topical Diclofenac Use in Musculoskeletal Disease. Pharmaceuticals,, 3, 1892-1908.
[42] Carnes D, Anwer Y, Underwood M, Harding G, Parsons S (2007). Influences on older people's decision making regarding choice of topical or oral NSAIDs for knee pain: qualitative study.BMJ. 2008 Jan 19; 336(7636):142-5. Epub Dec 4.
[43] Russell RI (1999). Defining patients at risk of NSAID gastropathy. Ital J Gastroenterol Hepatol; 31(suppl 1 S):14–18
Author Information
  • Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria

  • Department of Physiotherapy, College of Medicine, University of Malawi, Blantyre, Malawi

  • Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria

  • Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria

  • Department of Physiotherapy, University of the Western Cape, Bellville, South Africa

  • Department of Health and Rehabilitation Science, Faculty of Health Sciences, University Cape Town, Cape Town, South Africa

  • Rehabilitation Technician School, Malawi Against Physical Disabilities, P.O.Box 256, Blantyre, Malawi

  • Department of Physiotherapy, College of Medicine, University of Malawi, Blantyre, Malawi

Cite This Article
  • APA Style

    Onigbinde Ayodele Teslim, M’Kumbuzi Vyvienne, Olaogun Mathew Olatokunbo, Afolabi Joshua Oluwafisayo, Nondwe Bongokazi Mlenzana, et al. (2014). Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders. American Journal of Health Research, 2(4), 106-112. https://doi.org/10.11648/j.ajhr.20140204.11

    Copy | Download

    ACS Style

    Onigbinde Ayodele Teslim; M’Kumbuzi Vyvienne; Olaogun Mathew Olatokunbo; Afolabi Joshua Oluwafisayo; Nondwe Bongokazi Mlenzana, et al. Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders. Am. J. Health Res. 2014, 2(4), 106-112. doi: 10.11648/j.ajhr.20140204.11

    Copy | Download

    AMA Style

    Onigbinde Ayodele Teslim, M’Kumbuzi Vyvienne, Olaogun Mathew Olatokunbo, Afolabi Joshua Oluwafisayo, Nondwe Bongokazi Mlenzana, et al. Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders. Am J Health Res. 2014;2(4):106-112. doi: 10.11648/j.ajhr.20140204.11

    Copy | Download

  • @article{10.11648/j.ajhr.20140204.11,
      author = {Onigbinde Ayodele Teslim and M’Kumbuzi Vyvienne and Olaogun Mathew Olatokunbo and Afolabi Joshua Oluwafisayo and Nondwe Bongokazi Mlenzana and Manie Shamila and Tarimo Nesto and Mukoka Grace},
      title = {Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders},
      journal = {American Journal of Health Research},
      volume = {2},
      number = {4},
      pages = {106-112},
      doi = {10.11648/j.ajhr.20140204.11},
      url = {https://doi.org/10.11648/j.ajhr.20140204.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajhr.20140204.11},
      abstract = {Non-steroidal anti-inflammatory drugs (NSAIDs) are of choice for acute pain management in musculoskeletal disorders (MSDs) but they are not without side effects. The primary aim of this study was to investigate user’s experience of side effects of oral NSAIDs among patients with MSDs. Multi-stage sampling technique was used to select 296 patients with MSDs from physiotherapy out-patient clinics of five selected hospitals. A structured and close ended questionnaire was administered to investigate the side effects experienced by respondents. Descriptive statistics (mean, standard deviation, frequency and percentages) and Chi-square were used to compare the mean percentage difference in the knowledge of NSAIDs and their side effects. Only 15% of the respondents were able to recognize the listed side effects. A significant number of the respondents (58.7%) were not informed of the side effects of the NSAIDs at the time of prescription (Ӽ2 = 8.82, p = 0.003). About 33.4% and 31% of respondents identified dizziness and abdominal pain respectively as side effects. Sixty two (22.3%) respondents had experienced dizziness while 15.9% experienced abdominal pains. Diclofenac was the most frequently prescribed NSAID (153 [51.7%]). Only 2.0% and 2.7% of respondents were aware of phonophoresis and iontophoresis respectively as alternative means of administering NSAIDs where applicable. The Chi-square test revealed that the number of respondents that preferred alternative means of administration (where applicable) was significantly higher than those who preferred the oral routes (x2 = 74.5, p = 0.001).  We concluded that this sample of Nigerian patients was not informed of the side effects of NSAIDs by the prescribers. Dizziness and abdominal pains were the most experienced side effects. The role of alternative methods to administer NSAIDs need to be made available to patients where applicable to increase their health care choices.},
     year = {2014}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders
    AU  - Onigbinde Ayodele Teslim
    AU  - M’Kumbuzi Vyvienne
    AU  - Olaogun Mathew Olatokunbo
    AU  - Afolabi Joshua Oluwafisayo
    AU  - Nondwe Bongokazi Mlenzana
    AU  - Manie Shamila
    AU  - Tarimo Nesto
    AU  - Mukoka Grace
    Y1  - 2014/07/20
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ajhr.20140204.11
    DO  - 10.11648/j.ajhr.20140204.11
    T2  - American Journal of Health Research
    JF  - American Journal of Health Research
    JO  - American Journal of Health Research
    SP  - 106
    EP  - 112
    PB  - Science Publishing Group
    SN  - 2330-8796
    UR  - https://doi.org/10.11648/j.ajhr.20140204.11
    AB  - Non-steroidal anti-inflammatory drugs (NSAIDs) are of choice for acute pain management in musculoskeletal disorders (MSDs) but they are not without side effects. The primary aim of this study was to investigate user’s experience of side effects of oral NSAIDs among patients with MSDs. Multi-stage sampling technique was used to select 296 patients with MSDs from physiotherapy out-patient clinics of five selected hospitals. A structured and close ended questionnaire was administered to investigate the side effects experienced by respondents. Descriptive statistics (mean, standard deviation, frequency and percentages) and Chi-square were used to compare the mean percentage difference in the knowledge of NSAIDs and their side effects. Only 15% of the respondents were able to recognize the listed side effects. A significant number of the respondents (58.7%) were not informed of the side effects of the NSAIDs at the time of prescription (Ӽ2 = 8.82, p = 0.003). About 33.4% and 31% of respondents identified dizziness and abdominal pain respectively as side effects. Sixty two (22.3%) respondents had experienced dizziness while 15.9% experienced abdominal pains. Diclofenac was the most frequently prescribed NSAID (153 [51.7%]). Only 2.0% and 2.7% of respondents were aware of phonophoresis and iontophoresis respectively as alternative means of administering NSAIDs where applicable. The Chi-square test revealed that the number of respondents that preferred alternative means of administration (where applicable) was significantly higher than those who preferred the oral routes (x2 = 74.5, p = 0.001).  We concluded that this sample of Nigerian patients was not informed of the side effects of NSAIDs by the prescribers. Dizziness and abdominal pains were the most experienced side effects. The role of alternative methods to administer NSAIDs need to be made available to patients where applicable to increase their health care choices.
    VL  - 2
    IS  - 4
    ER  - 

    Copy | Download

  • Sections