D . Deepjyo i Che ia e al. B idging he Gap: Knowledge, A i ude and P ac ice o Heal hca e P o essionals on NSAID
Sa e y in a Te ia y Ca e Teaching Hospi al in Maha ash a, India. In . J Med. Pha m. Res., 6 (6): 206‐210, 2025
206
In e na ional Jou nal o Medical
and Pha maceu ical Resea ch
Online ISSN-2958-3683 | P in ISSN-2958-3675
F equency: Bi-Mon hly
A ailable online on: h ps://ijmp .in/
O iginal A icle
B idging he Gap: Knowledge, A i ude and P ac ice o Heal hca e
P o essionals on NSAID Sa e y in a Te ia y Ca e Teaching Hospi al in
Maha ash a, India
D . Deepjyo i Che ia1, D . A inash V Tu anka 2, D . Sampu na Bo bo a3
1 Junio Residen , Depa men o Pha macology, Go e nmen Medical College, Nagpu , India
2 P o esso and Head, Depa men o Pha macology, Go e nmen Medical College, Nagpu , India
3 Assis an P o esso , Da a Meghe Medical College, Nagpu , India
A B S T R A C T
Co esponding Au ho :
D . Deepjyo i Che ia
Junio Residen , Depa men o
Pha macology, Go e nmen
Medical College, Nagpu , India.
Recei ed: 14-10-2025
Accep ed: 29-10-2025
A ailable online: 12-11-2025
Aim and Objec i e: To e alua e he knowledge, a i udes and p ac ices (KAP) o
heal hca e p o essionals (HCPs) conce ning Nons e oidal An i-In lamma o y D ug
(NSAID) Sa e y in a e ia y ca e eaching hospi al in Maha ash a, India.
Ma e ials and Me hods: This s udy was a c oss-sec ional, ques ionnai e-based
s udy, conduc ed among 200 heal hca e p o essionals (HCPs) a a e ia y ca e
eaching hospi al in India. The da a o his s udy was collec ed using a sel -
designed, p e- alida ed ques ionnai e, which e alua ed KAP on NSAID sa e y,
including p esc ibing pa e ns, isk awa eness and mi iga ion s a egies.
Desc ip i e s a is ics we e used o analysis.
Resul s: Mos pa icipan s (92%) co ec ly iden i ied COX enzyme inhibi ion as
he p ima y mechanism o NSAIDs. Howe e , gaps we e obse ed in isk
awa eness (e.g., only 60% ecognized ke o olac as ha ing he highes
gas oin es inal oxici y). While 88% exp essed conce n abou gas oin es inal side
e ec s, only 80% ou inely co-p esc ibed gas op o ec i e agen s in high- isk
pa ien s. O e - he-coun e a ailabili y (85%) and pa ien non-compliance (72%)
we e ci ed as majo challenges.
Conclusion: This s udy highligh s ha despi e ha ing adequa e ounda ional
knowledge, ce ains gaps pe sis in isk awa eness and mi iga ion p ac ices o
heal hca e p o essionals. Educa ional in e en ions and s ic e p esc ibing
guidelines a e needed o imp o e sa e y o NSAID use.
Copy igh © In e na ional Jou nal o
Medical and Pha maceu ical Resea ch
Keywo ds: NSAIDs, d ug sa e y, heal hca e p o essionals, knowledge‐a i ude‐
p ac ice, India.
INTRODUCTION
Nons e oidal an i-in lamma o y d ugs (NSAIDs) a e among he mos widely p esc ibed and consumed medica ions
wo ldwide, p ima ily o he ea men o pain, e e , and in lamma ion. Thei popula i y s ems om hei p o en e icacy,
widesp ead a ailabili y, and ela i e a o dabili y. Howe e , despi e hese he apeu ic bene i s, NSAIDs a e associa ed wi h
a ange o ad e se e ec s ha wa an cau ious use, pa icula ly when used wi hou medical supe ision (Bindu e al, 2020).
The Wo ld Heal h O ganiza ion has consis en ly ad oca ed o a ional medica ion use, ye mul iple s udies demons a e
pe sis en issues wi h NSAID misuse h ough imp ope p esc ibing pa e ns (Whi ne e al, 2020), widesp ead sel -
medica ion p ac ices and lack o p ope awa eness ega ding hei isks (K asniqi e al, 2024). Common ad e se e ec s o
NSAIDs include gas oin es inal (GI) bleeding, ca dio ascula isks, and enal impai men (Wong akpanich e al, 2018).
In popula ions p edisposed o GI bleed, such as he elde ly o hose wi h como bidi ies, concomi an p esc ip ion o p o on
pump inhibi o s (PPIs) (Sca pigna o e al, 2016) and ca e ul moni o ing (Bindu e al., 2020) is c ucial. While COX-2
inhibi o s we e ini ially ma ke ed as o e all sa e al e na i es, e idence has shown hey a e no de oid o ca dio ascula
D . Deepjyo i Che ia e al. B idging he Gap: Knowledge, A i ude and P ac ice o Heal hca e P o essionals on NSAID
Sa e y in a Te ia y Ca e Teaching Hospi al in Maha ash a, India. In . J Med. Pha m. Res., 6 (6): 206‐210, 2025
207
isks (Kea ney e al., 2006). These challenges a e pa icula ly conce ning in India, whe e lack o s ic egula ion o o e -
he-coun e d ug sales exace ba es he po en ial isks (Kuma e al 2023).
Heal hca e p o essionals se e as ga ekeepe s o ensu ing app op ia e NSAID u iliza ion, and he e o e hei
unde s anding and app oach ega ding NSAID sa e y is o pa amoun impo ance. P io s udies highligh a iabili y and
gaps in NSAID p esc ibing pa e ns and isk awa eness among heal hca e p o essionals (Gondane e al, 2024), (Ho KY,
2020), which emphasizes he need o localized s udies. This s udy was he e o e designed o sys ema ically e alua e he
knowledge, a i udes, and p ac ices conce ning NSAID sa e y among heal hca e p o essionals in a e ia y ca e eaching
hospi al in Maha ash a, wi h he goal o iden i ying speci ic a eas equi ing in e en ion and imp o emen .
MATERIAL AND METHODS
S udy design and se ing: This s udy was a c oss-sec ional, su ey-based s udy conduc ed o assess he knowledge,
a i udes, and p ac ices o HCPs ega ding NSAID sa e y, a a e ia y ca e eaching hospi al in India. The s udy was
conduc ed a e ob aining app o al om he Ins i u ional E hics Commi ee (IEC).
In o med consen was aken om all s udy pa icipan s.
S udy du a ion: The s udy was conduc ed o a du a ion o wo mon hs, s a ing om 20s o Ma ch 2025. The inclusion
c i e ia o pa icipan s in his s udy was heal hca e p o essionals willing o pa icipa e in he s udy. The exclusion c i e ia
was HCPs who submi ed incomple ely illed ques ionnai e.
Da a Collec ion Me hods and Tools: The da a o his s udy we e collec ed h ough a sel - designed, semi-s uc u ed, p e-
alida ed ques ionnai e ci cula ed h ough Google o ms o HCPs. The ques ionnai e consis ed o ques ions ela ed o
knowledge, a i udes, and p ac ices ela ed o NSAID sa e y. The ques ionnai e was alida ed by ci cula ing i o a panel o
10 expe s in he subjec who we e asked o e iew and e alua e he design, con en , and ele ance o he ques ionnai e as
well as assess i s comp ehensibili y and eadabili y which was consequen ly modi ied sligh ly based on hei eedback. The
esponses we e hen collec ed anonymously.
S udy p ocedu e: The ques ionnai e was s uc u ed wi h a o al o 21 ques ions– ou o which 10 we e abou knowledge,
6 abou a i ude and 5 abou p ac ice, designed speci ically o de e mine awa eness abou NSAID sa e y. Be o e
commencemen o he ques ionnai e, he objec i es o he s udy we e men ioned in he google o ms. I was assu ed ha
he da a which was collec ed would be used only o esea ch pu poses and he iden i y o pa icipan s will emain
anonymous.
S a is ical Analysis:
The collec ed da a was analyzed using desc ip i e s a is ics such as pe cen ages.
RESULTS
A o al o 200 heal hca e p o essionals pa icipa ed in his c oss-sec ional s udy, including esiden doc o s (52.5%), MBBS
in e ns (11%), esiden den is s (30%), and nu sing s a (6.5%). Mo e han hal o hem (53.5%) had less han 1 yea o
expe ience, and majo i y o hem (65%) p esc ibed NSAIDs daily o a leas se e al imes a week. (Table 1)
Table 1: Demog aphic Highligh s
Demog aphic Pa ame e s (N = 200)
Values
Wo k P o ile
Residen Doc o s
105 (52.5%)
MBBS In e ns
22 (11%)
Residen Den is s
60 (30%)
Nu sing S a
13 (6.5%)
Yea s o P ac ice
<1 yea
107 (53.5%)
1- 3 yea s
43 (21.5%)
3- 5 yea s
25 (12.5%)
>5 yea s
25 (12.5%)
P esc ip ion F equency
Daily/Se e al imes a week
65%
Ra ely
15%
D . Deepjyo i Che ia e al. B idging he Gap: Knowledge, A i ude and P ac ice o Heal hca e P o essionals on NSAID
Sa e y in a Te ia y Ca e Teaching Hospi al in Maha ash a, India. In . J Med. Pha m. Res., 6 (6): 206‐210, 2025
208
Wi h espec o knowledge, he majo i y o pa icipan s demons a ed a sound unde s anding o he pha macological
mechanism o NSAIDs, wi h 95% co ec ly iden i ying COX enzyme inhibi ion as he p ima y mode o ac ion. When
ques ioned abou gas oin es inal (GI) oxici y isk, Ke o olac (40%) was mos equen ly ci ed as ha ing highes oxici y.
Nap oxen (60%) was accu a ely iden i ied as a sa e choice in pa ien s wi h ca dio ascula como bidi ies.
Despi e his, ce ain knowledge gaps we e iden i ied. App oxima ely 20% o esponden s e oneously belie ed ha COX-
2 inhibi o s such as celecoxib ca y no ca dio ascula isk. Fu he mo e, 15% misiden i ied he NSAID sa es o use
du ing p egnancy, highligh ing he need o imp o ed educa ion on NSAID isk s a i ica ion.
A i udinal esponses e lec ed a gene ally cau ious app oach. A combined 88% o esponden s epo ed being ei he " e y
conce ned" o "somewha conce ned" abou NSAID-induced GI side e ec s. Addi ionally, 45% opposed he a ailabili y
o NSAIDs as o e - he-coun e (OTC) medica ions, ci ing po en ial misuse and lack o supe ision. (Figu e 1)
Figu e 1: Should NSAIDs be a ailable wi hou p esc ip ion?
Pa icipan s s ongly endo sed in e en ions o p omo e sa e NSAID use. 75% suppo ed s ic e OTC egula ions, 70%
a ou ed egula Con inuing Medical Educa ion (CME) sessions, and 60% ecommended in eg a ion o isk assessmen
ools in o clinics.
P ac ice pa e ns a ied among esponden s. The mos commonly p esc ibed NSAIDs included Diclo enac (30%),
Aceclo enac (25%), and Ibup o en (20%). While mos clinicians adhe ed o sa e y measu es, 20% epo ed no consis en ly
co-p esc ibing p o on pump inhibi o s (PPIs) in high- isk pa ien s ecei ing NSAIDs. This aises conce n, especially in
hose p edisposed o GI complica ions. Also, no ably, in esponse o ques ion ega ding how o en hey educa e pa ien s
abou NSAID isks, we ound ha mo e han hal o he esponden s (56%) educa e hei pa ien s only ‘some imes’.
Figu e 2: Al hough 88% o esponden s we e somewha o e y conce ned abou GI isks, only 80% co-p esc ibed
PPIs. This is a c i ical disconnec . Expe ienced p esc ibe s b idge his gap be e .
49.70% 45.20%
0.00% 20.00% 40.00% 60.00% 80.00% 100.00% 120.00%
Yes, o all pa ien s Only sho - e m use No, always p esc ip ion
88%
85%
65%
80%
90%
50%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
All Responden s
Expe ience >5 y s
Expe ience <1 y
Ve y o Somewha Conce ned Always Co-P esc ibe PPIs
D . Deepjyo i Che ia e al. B idging he Gap: Knowledge, A i ude and P ac ice o Heal hca e P o essionals on NSAID
Sa e y in a Te ia y Ca e Teaching Hospi al in Maha ash a, India. In . J Med. Pha m. Res., 6 (6): 206‐210, 2025
209
Sel -medica ion and un egula ed use we e also no ed, wi h 30% o heal hca e p o essionals epo ing obse ed misuse o
NSAIDs among hei pee s. Moni o ing o labo a o y pa ame e s was gene ally adequa e, wi h 75% checking enal
unc ion, 60% moni o ing li e unc ion, and 40% assessing coagula ion p o iles in pa ien s on long- e m NSAID he apy.
Howe e , 25% admi ed o a ely moni o ing elec oly e le els, despi e hei clinical ele ance in p olonged NSAID use.
DISCUSSION
The indings o his s udy e eal bo h s eng hs and gaps in HCPs' knowledge, a i udes, and p ac ices conce ning NSAID
sa e y. A high p opo ion (95%) co ec ly iden i ied COX inhibi ion as he p ima y mechanism o NSAIDs, aligning wi h
es ablished pha macological p inciples (Vane & Bo ing, 1998). Howe e , 20% e oneously belie ed COX-2 inhibi o s
had no ca dio ascula isk, a misconcep ion con adic ed by obus e idence (Kea ney e al, 2006). This highligh s he need
o ongoing educa ion on NSAID pha macodynamics.
A c i ical gap iden i ied in his s udy was he ailu e o HCPs o ou inely educa e pa ien s abou NSAID isks. This inding
aligns wi h p io esea ch indica ing ha pa ien counseling on NSAID- ela ed ad e se e ec s is o en o e looked
(Ja e nsi ipo nkul e al, 2019), (Phueanpini e al, 2017). P ope pa ien educa ion is essen ial o mi iga e sel -medica ion
isks, pa icula ly gi en he widesp ead OTC a ailabili y o NSAIDs. S udies ha e shown ha in o med pa ien s a e less
likely o misuse NSAIDs and mo e likely o adhe e o p o ec i e measu es, such as PPI co- he apy (Laine e al, 2009). The
lack o s uc u ed pa ien counseling in his s udy sugges s a missed oppo uni y o enhance medica ion sa e y.
Ke o olac was ci ed o GI oxici y, consis en wi h li e a u e (Ga cia e al, 1998), while nap oxen was co ec ly ecognized
as sa e o ca dio ascula pa ien s (Ray e al, 2009). Despi e his awa eness, 20% o esponden s did no consis en ly co-
p esc ibe PPIs o high- isk pa ien s, a p ac ice s ongly ecommended by guidelines (Sca pigna o e al, 2016). This
disc epancy be ween knowledge and p ac ice has been documen ed in o he se ings, whe e ime cons ain s and clinical
ine ia con ibu e o subop imal adhe ence (Tsiga e al, 2013).
No ably, 30% o esponden s obse ed sel -medica ion among HCPs hemsel es, a conce ning end gi en hei ole in
modeling app op ia e medica ion use (Hem e al, 2005). Moni o ing p ac ices we e also subop imal, wi h 25% a ely
checking elec oly es du ing long- e m NSAID use, despi e known isks o NSAID-induced elec oly e imbalances (De
Ma co e al, 2024).
Responden s ad oca ed o s ic e OTC egula ions (75%), egula aining (70%), and in eg a ion o isk assessmen ools
(60%), mi o ing ecommenda ions om p io s udies (Ca azos e al, 2008). Howe e , he addi ion o s uc u ed pa ien
educa ion p og ams should be p io i ized, as in o med pa ien s a e c i ical pa ne s in educing NSAID- ela ed ha m.
Limi a ions:
The s udy only includes pa icipan s om a speci ic hospi al, limi ing gene alizabili y o esul s o o he se ings o
popula ions. The knowledge and a i udes o heal hca e p o essionals can a y widely based on loca ion and expe ience.
Sel - epo ed da a is subjec o ecall bias and is hus a con ounding ac o .
CONCLUSION
In conclusion, while HCPs demons a ed sound ounda ional knowledge, c i ical gaps pe sis in p ac ice, pa icula ly in
pa ien educa ion. To ackle his, mul i ace ed in e en ions - combining educa ion, policy changes, and clinical ools - a e
essen ial o minimize NSAID- ela ed isks.
Con lic s o in e es : Nil
Sou ces o unding: Nil
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