Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Prescription NSAID Use in High-Risk Patients

JAMA Intern Med; ePub 2018 Oct 8; Bouck, et al

Among patients with a musculoskeletal disorder and hypertension, heart failure (HF), or chronic kidney disease (CKD), prescription nonsteroidal anti-inflammatory drug (NSAID) use was common in high-risk patients; however, use was not associated with increased risk of short-term, safety-related outcomes. This according to a retrospective cohort study of primary care patients (aged ≥65 years) with a musculoskeletal disorder and a history of hypertension, HF, or CKD between April 1, 2012, and March 31, 2016. Multiple cardiovascular and renal safety-related outcomes were observed between 8 and 37 days after each visit. Researchers found:

  • Among a retrospective cohort of 2,415,291 musculoskeletal-related primary care visits by 814,049 older adult patients with hypertension, HF, or CKD, 9.3% of visits resulted in prescription NSAID use within the following 7 days.
  • The median physician-level prescribing rate was 11.0% with widespread physician-level variation.
  • Prescription NSAID use was not associated with increased risk of safety-related outcomes at 37 days.

Citation:

Bouck Z, Mecredy GC, Ivers NM, et al. Frequency and associations of prescription nonsteroidal anti-inflammatory drug use among patients with a musculoskeletal disorder and hypertension, heart failure, or chronic kidney disease. [Published online ahead of print October 8, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.4273.

This Week's Must Reads

CVD Events Prevented with New AHA BP Guideline, Circulation; ePub 2018 Nov 19; Bress, et al

USPSTF: Interventions to Prevent Child Maltreatment, JAMA; 2018 Nov 27; US Preventive Services Task Force

Team-Based Primary Care in Chronically Ill Patients, JAMA Intern Med; ePub 2018 Nov 26; Meyers, et al

Rotating Night Shift Work & Risk of T2D, BMJ; ePub 2018 Nov 21; Shan, Li, et al

PUFAs for Primary & Secondary CVD Prevention, Cochrane Library; ePub 2018 Nov 27; Abdelhamid, et al

Must Reads in Cardiology

CVD Events Prevented with New AHA BP Guideline, Circulation; ePub 2018 Nov 19; Bress, et al

PUFAs for Primary & Secondary CVD Prevention, Cochrane Library; ePub 2018 Nov 27; Abdelhamid, et al

Is Obesity Associated With Adverse CV Outcomes?, JAMA Netw Open; 2018 Nov 16; Riaz, et al

Cholesterol Guidelines Stress Lifetime Approach, Circulation; ePub 2018 Nov 10; Grundy, et al

Does Vitamin D Reduce Cancer & CVD Risk?, N Engl J Med; ePub 2018 Nov 10; Manson, et al