RT Journal Article
SR Electronic
T1 Non-steroidal anti-inflammatory drugs for pain in hospice/palliative care: an international pharmacovigilance study
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP spcare-2022-004154
DO 10.1136/spcare-2022-004154
A1 McNeill, Richard
A1 Boland, Jason W
A1 Wilcock, Andrew
A1 Sinnarajah, Aynharan
A1 Currow, David C
YR 2023
UL http://spcare.bmj.com/content/early/2023/05/01/spcare-2022-004154.abstract
AB Objectives To describe the current, real-world use of non-steroidal anti-inflammatory drugs for pain and the associated benefits and harms.Methods A prospective, multicentre, consecutive cohort pharmacovigilance study conducted at 14 sites across Australia, Aotearoa/New Zealand and the UK including hospital, hospice inpatient and outpatient services. Pain scores and harms were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events at baseline, 2 days and 14 days. Ad-hoc safety reporting continued until day 28.Results Data were collected from 92 patients between March 2018 and October 2021. Most patients had cancer (91%) and were coprescribed opioids (90%). At 14 days, 83% of patients had benefit from non-steroidal anti-inflammatory drugs and 22% had harm. The most common harms were nausea (8%), vomiting (3%), acute kidney injury (3%) and non-gastrointestinal bleeding (3%); only 2% were severe and no patients ceased their non-steroidal anti-inflammatory drugs due to toxicity. Overall, 65% had benefit without harm and 3% had harm without benefit.Conclusions Most patients benefited from non-steroidal anti-inflammatory drugs with only one in five patients experiencing tolerable harm. This suggests that short-term use of non-steroidal anti-inflammatory drugs in patients receiving palliative care is safer than previously thought and may be underused.Data are available upon request.