Cookie policy notice

By continuing to use this site you agree to our cookies policy below:
Since 26 May 2011, the law now states that cookies on websites can ony be used with your specific consent. Cookies allow us to ensure that you enjoy the best browsing experience.

This site is intended for health professionals only

At the heart of general practice since 1960

GPs risk litigation for ignoring Government advice on NSAIDs

GPs have been warned they risk litigation if they continue to prescribe standard non-steroidal anti-inflammatory drugs to high-risk patients.

The Primary Care Rheum-atology Society claimed a considerable number of GPs continued to prescribe regular NSAIDs to high-risk patients with osteoarthritis despite Government guidance recommending Cox-2 selective inhibitors.

The National Institute for Clinical Excellence ruled in 2001 that Cox-2s should be prescribed for high-risk patients, including patients aged over 65, instead of standard NSAIDs for osteoarthritis.

But NICE estimated the guidance would cost the NHS £25 million a year.

Dr Graham Davenport, chair of the society and a GP in Nantwich, Cheshire, warned GPs could end up in court if a patient suffered an adverse event related to standard NSAID prescribing, such as a GI bleed or even death.

Dr Davenport, a member of Cheshire LMC, said GPs tended to prescribe standard NSAIDs because of pressure from PCTs to stay within their drug budgets.

But he said: 'GPs would find it very difficult to justify prescribing standard non-steroidals if a patient died. You could be in very big trouble and end up in court.'

Dr Davenport was recently criticised by his local PCT for having too many patients on Cox-2s instead of standard NSAIDs, which had strained his practice's drug budget.

But the PCT backed off

after he referred to the NICE guidance.

He said: 'PCTs are now fully aware of NICE guidance and they realise that Cox-2s will result in less GI complications. It is unfortunate for GPs that primary care will bear the brunt of the cost.'

The Primary Care Rheum-atology Society said osteo-arthritis accounted for about 40 consultations per GP per week and was present in about 80 per cent of the over-70s.

Dr Andrei Calin, consultant rheumatologist at The Royal National Hospital for Rheu-matic Diseases in Bath, estimated wider use of Cox-2s would halve the death rate linked to adverse effects of standard NSAIDs and any increase in cost would be offset by savings in secondary care.

'Cox-2 inhibitors are perhaps twice as expensive, but virtually every study confirms that by taking these, half as many patients suffer a massive GI bleed, perforate their bowel, require emergency transport to hospital, are admitted and half as much will be transfused.

'Given some 2,500-3,000 patients die each year from using conventional NSAIDs, twice as many lives could be saved.

'We anticipate the death rate to reduce to perhaps 1,000-1,500 per annum.'

Rate this article 

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say