Racial/ethnic disparities in patient-reported nonsteroidal antiinflammatory drug (NSAID) risk awareness, patient-doctor NSAID risk communication, and NSAID risk behavior.

Academic Article


  • 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.
  • Published In


  • 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
  • Digital Object Identifier (doi)

    Author List

  • Fry RB; Ray MN; Cobaugh DJ; Weissman NW; Kiefe CI; Shewchuk RM; Saag KG; Curtis JR; Allison JJ
  • Start Page

  • 1539
  • End Page

  • 1545
  • Volume

  • 57
  • Issue

  • 8