Racial/ethnic disparities in patient-reported nonsteroidal antiinflammatory drug (NSAID) risk awareness, patient-doctor NSAID risk communication, and NSAID risk behavior
Department of Quantitative Health Sciences
Medical Subject Headings
African Americans; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Awareness; *Communication; Cross-Sectional Studies; European Continental Ancestry Group; Female; Gastrointestinal Diseases; Healthcare Disparities; Humans; Income; Male; Middle Aged; Odds Ratio; Patient Education as Topic; *Physician-Patient Relations; Rheumatic Diseases; Risk Factors; Risk-Taking
Bioinformatics | Biostatistics | Epidemiology | Health Services Research
OBJECTIVE: Nonsteroidal antiinflammatory drugs (NSAIDs) are commonly used and frequently lead to serious adverse events. Little is known about NSAID-related ethnic/racial disparities. We focused on differences in patient NSAID risk awareness, patient-doctor NSAID risk communication, and NSAID risk-avoidance behavior.
METHODS: We performed a cross-sectional analysis of survey data from the Alabama NSAID Patient Safety Study. Eligible patients were > or = 65 years old and currently taking prescription NSAIDs (Rx NSAIDS). Generalized linear latent and mixed models accounted for nesting of patients within physicians.
RESULTS: Of all 404 participants, 32% were African American and 73% were female. The mean +/- SD age was 72.8 +/- 7.5 years, and 64% reported an annual household income <$20,000. African American patients were less likely than white patients to recognize any risk associated with over-the-counter (OTC) NSAIDs (13.3% versus 29.3%; P = 0.001) and Rx NSAIDs (31.3% versus 49.6%; P = 0.001), report that their doctor discussed possible NSAID-related gastrointestinal problems (38.0% versus 52.4%; P = 0.007), and take medications to reduce ulcer risk (30.5% versus 50.2%; P = 0.001). Patients with lower income and education reported significantly less risk awareness for OTC and Rx NSAIDs. Racial/ethnic differences persisted after adjusting for multiple confounders.
CONCLUSION: In this community-based study of low income elderly individuals receiving NSAIDs, we identified important racial/ethnic differences in risk awareness, communication, and behavior. Additional efforts are needed to promote safe NSAID use and reduce ethnic/racial disparities.
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Citation: Arthritis Rheum. 2007 Dec 15;57(8):1539-45. Link to article on publisher's site
Fry, Rachel B.; Ray, Midge N.; Cobaugh, Daniel J.; Weissman, Norman W.; Kiefe, Catarina I.; Shewchuk, Richard M.; Saag, Kenneth G.; Curtis, Jeffrey R.; and Allison, Jeroan J., "Racial/ethnic disparities in patient-reported nonsteroidal antiinflammatory drug (NSAID) risk awareness, patient-doctor NSAID risk communication, and NSAID risk behavior" (2007). Quantitative Health Sciences Publications and Presentations. 38.