Non-steroidal anti-inflammatory drugs for pain in hospice/palliative care: an international pharmacovigilance study.

McNeill, R; Boland, JW; Wilcock, A; Sinnarajah, A; Currow, DC

Non-steroidal anti-inflammatory drugs for pain in hospice/palliative care: an international pharmacovigilance study.

McNeill, R Boland, JW Wilcock, A Sinnarajah, A Currow, DC

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Publisher:: BMJ Publishing Group
Publication Type:: Journal Article
Citation:: BMJ Supportive and Palliative Care, 2023, 13, (e3), pp. 1249-1257
Issue Date:: 2023-01-31

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Field	Value	Language
dc.contributor.author	McNeill, R
dc.contributor.author	Boland, JW
dc.contributor.author	Wilcock, A
dc.contributor.author	Sinnarajah, A
dc.contributor.author	Currow, DC
dc.date.accessioned	2024-03-07T04:58:14Z
dc.date.available	2023-01-10
dc.date.available	2024-03-07T04:58:14Z
dc.date.issued	2023-01-31
dc.identifier.citation	BMJ Supportive and Palliative Care, 2023, 13, (e3), pp. 1249-1257
dc.identifier.issn	2045-435X
dc.identifier.issn	2045-4368
dc.identifier.uri	http://hdl.handle.net/10453/176268
dc.description.abstract	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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	BMJ Publishing Group
dc.relation.ispartof	BMJ Supportive and Palliative Care
dc.relation.isbasedon	10.1136/spcare-2022-004154
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4205 Nursing
dc.title	Non-steroidal anti-inflammatory drugs for pain in hospice/palliative care: an international pharmacovigilance study.
dc.type	Journal Article
utslib.citation.volume	13
utslib.location.activity	England
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2024-03-07T04:58:13Z
pubs.issue	e3
pubs.publication-status	Published online
pubs.volume	13
utslib.citation.issue	e3

Abstract:

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.

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http://hdl.handle.net/10453/176268