Highest NSAID Usage Levels in Working Age Adults Linked to Greater Risk of Kidney Disease

MedicalResearch.com Interview with:
Alan Nelson, MPAS, PhD
Division of Primary Care and Population Health, Department of Medicine
Stanford University School of Medicine
Stanford, California 

MedicalResearch.com: What is the background for this study?  

Response: The past research literature has provided relatively little information on the appropriate level of concern regarding non-steroidal anti-inflammatory drugs (NSAIDs) and kidney disease risk among younger, apparently healthy patients. Clinicians are generally most concerned about the effects of these medications on the kidneys among patients with existing renal impairment and persons at risk for it, especially older patients.

Given that NSAID use appears to be high and rising in the US, we were interested in developing evidence on this topic in a population of working-age adults.

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All NSAIDS Raise Risk of Heart Attack, Even When Taken For Short Period of Time

MedicalResearch.com Interview with:
Michèle Bally, BPharm, MSc, PhD

Epidemiologist, Department of Pharmacy, CHUM
Researcher, Health Innovation and Evaluation Hub, CRCHUM

MedicalResearch.com: What is the background for this study?

Response: The objective of this study was to better understand the risk of heart attack associated with using oral prescription non-steroidal anti-inflammatory drugs or NSAIDs (ibuprofen, diclofenac, celecoxib, and naproxen) the way people usually do to treat pain and inflammation in real life circumstances. A lot of people take medication, but they do not understand that some can be more harmful than beneficial, especially with consistent use. Unfortunately, something like a heart attack can happen anywhere. You could be at work and show signs of an attack. If this does happen, hopefully you have someone who is first aid trained to at least help you deal with these symptoms, until you get to the hospital. This is why having someone who knows that they are doing is beneficial in any environment. If it wasn’t for companies like Coast2Coast in Ottawa, the chances of someone who was suffering from a heart attack may not have made it to the hospital if it wasn’t for the assistance of someone who was first aid trained.

In clinical trials, NSAIDs were typically taken on a continuous basis in high standardized doses, as assigned by the trial protocol. However, the dosages and the treatment durations studied in trials may not represent the reality of many patients who use NSAIDs in low or varying doses, use these drugs on and off, or switch between NSAID medications.

We were particularly interested in determining the onset of the risk, that is how soon does the risk of heart attack start increasing? Also, we wanted to investigate the effect of dose and duration of treatment. To do this, we studied the use of a low or high dose level of NSAIDs over certain set periods of time, including taking these medications only for 1 to 7 days.

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Repeat Urine Drug Testing Can Improve Compliance of Patients on Opioid Medications

MedicalResearch.com Interview with:

N. Nick Knezevic, MD, PhD Vice Chair for Research and Education Associate Professor of Anesthesiology and Surgery at University of Illinois Advocate Illinois Masonic Medical Center Department of Anesthesiology Chicago, IL 60657

Dr. N. Nick Knezevic

N. Nick Knezevic, MD, PhD
Vice Chair for Research and Education
Associate Professor of Anesthesiology and Surgery at University of Illinois
Advocate Illinois Masonic Medical Center
Department of Anesthesiology
Chicago, IL 60657

MedicalResearch.com: What is the background for this study?

Response: Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic non-cancer pain, still many Americans seek pain relief through opioid consumption. The purpose of this study was to accurately assess compliance of chronic opioid consuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing could improve compliance.

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Emergency Room Prescriptions for Opioid Pain Medications Markedly Increase

Maryann Mazer-Amirshahi PharmD, MD1MedicalResearch.com Interview with:
Maryann Mazer-Amirshahi PharmD, MD
The Department of Emergency Medicine, The George Washington University
The Department of Clinical Pharmacology, Children’s National Medical Center, Washington, DC

MedicalResearch.com: What are the main findings of the study?

Answer: We found a significant increase in the prescribing of opioid pain medications in the emergency department. At the same time, this was not accounted for by a similar increase in pain-related visits and prescribing patterns of non-opioid analgesics did not change.

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