Informed choice and the widespread use of antiinflammatory drugs
Article first published online: 5 APR 2004
Copyright © 2004 by the American College of Rheumatology
Arthritis Care & Research
Volume 51, Issue 2, pages 210–214, 15 April 2004
How to Cite
Fraenkel, L., Wittink, D. R., Concato, J. and Fried, T. (2004), Informed choice and the widespread use of antiinflammatory drugs. Arthritis & Rheumatism, 51: 210–214. doi: 10.1002/art.20247
- Issue published online: 5 APR 2004
- Article first published online: 5 APR 2004
- Manuscript Accepted: 2 JUL 2003
- Manuscript Received: 23 FEB 2003
- VA Career Development Award
- NIA. Grant Number: K02-AG20113
- Study of Health Care Relationships
- Yale University and the University of Connecticut
- Donaghue Medical Research Foundation
- Yale Pepper Center
- Nonsteroidal antiinflammatory drugs;
- Cyclooxygenase 2 inhibitors
To examine whether the current widespread use of antiinflammatory drugs may reflect a lack of informed choice (i.e., unawareness of adverse effects or potential treatment alternatives) among older patients with knee osteoarthritis (OA).
Consecutive patients with symptomatic knee OA (n = 100) completed a questionnaire to assess their awareness of drug toxicity. Patients also completed an Adaptive Conjoint Analysis task so that the influence of providing an additional treatment alternative on patient preferences for nonselective nonsteroidal antiinflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors could be assessed.
Fifty-four percent of the patients surveyed were unaware of any adverse effects related to NSAIDs and 80% were unaware of any toxicity related to COX-2 inhibitors. When given a choice between NSAIDs and COX-2 inhibitors, 57% of patients preferred COX-2 inhibitors over NSAIDs. When presented with a third less effective, but safer alternative, 100% of patients switched preferences to the safer, albeit less effective, option.
Our findings suggest that the widespread use of NSAIDs may reflect lack of informed choice among older patients with OA.