|
| Physician barriers | Patient barriers |
|
| (1) Limited awareness of or failure to adhere to available NSAIDs Guidelines | (1) Barriers to patient education regarding the proper use of medications |
| (a) Too many guidelines | (a) Power of TV ads on decision for what medications to take |
| (b) Confusion about which guidelines are applicable to what segment of the elderly population | (b) Limited awareness of the risks associated with medications |
| (2) Barriers to using available and up-to-date knowledge on NSAIDs | (2) Failure to objectively, properly, and safely alleviate pain |
| (a) Prevalence and intensity of pain sometimes clouds patients’ reasoning and leads to unsafe medication intake behavior |
| (3) Inability of primary health care providers to pursue education/training on how to adjust some of the medical practice aspects to the geriatric population | (3) Economic factors |
| (a) Cost of copayments sometimes deter from seeking professional and appropriate prescriptions |
| (4) Barriers to optimally manage patient’s pain which leads the patient to seek other sources of alleviating it | (4) Misperception about the safety of OTC medications |
| (a) Risk of overdosing, drug-drug interactions, and chronic use |
| (b) Failure to recognize or legitimize the tell-tale signs of adverse events |
| (5) Limited physician-patient interchange regarding proper use and what to expect | (5) Limited awareness of NSAID sources |
| (a) OTC |
| (b) Prescription |
| (6) Absence of systematic screening, monitoring, and educational procedures for prevention | |
| (a) Identify patients at high risk of renal impairment, GI bleed, cardiovascular side effects, and other AEs and manage them appropriately | |
| (b) Ask/document OTC use including NSAIDs and dietary supplements | |
| (c) Warn patients about specific NSAID serious adverse events | |
| (d) Make patient aware of medications that interact with NSAIDs | |
| (e) Educate patient about the risk of long-term use of NSAIDs | |
| (i) Ex. patients at high risk of CVD | |
| (f) Prescribe prophylactic measures | |
| (i) Ex. proton pump inhibitors | |
| (7) Barriers to the use of new technological tools to improve prescribing | |
| (8) Limited awareness of and evidence-based practice for nonpharmacologic approaches to pain reduction | |
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