Double trouble

People who use two or more non-steroidal anti-inflammatory drugs (NSAIDs) to help control pain have a worse health-related quality of life than their peers who use only one, results of a study suggest.

"Patients may self-manage their pain to improve their daily activities by taking more than one NSAID. However, by attempting to obtain symptom relief, patients may be putting themselves at risk for complications," Dr Stacey H. Kovac, from the Durham VA Medical Centre in North Carolina, and colleagues note in the medical journal Arthritis Care and Research.

Factfile: NSAIDS Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. The most prominent members of this group of drugs are aspirin, ibuprofen, and naproxen partly because they are available over-the-counter in many areas. Paracetamol (acetaminophen) has negligible anti-inflammatory activity, and is strictly speaking not an NSAID.

Prior research has established a strong link between multiple NSAID use and gastrointestinal problems, but it was unclear if this practice affected health-related quality-of-life.

To investigate, Kovac's team interviewed 138 patients from a large regional managed care organization who had filled one or more NSAID prescription between February and August 2002.

Overall, 26 per cent of subjects used two or more NSAIDs, the report indicates. These patients scored lower on the physical component of a quality of life questionnaire than did single-NSAID users, suggesting a poorer health-related quality of life.

Whether multiple NSAID use impairs health-related quality of life itself or whether it simply reflects a more severe underlying disease that is responsible will require further study, the investigators note.