{"id":4427,"date":"2022-10-07T15:40:42","date_gmt":"2022-10-07T14:40:42","guid":{"rendered":"https:\/\/cdrc.nhs.uk\/?page_id=4427"},"modified":"2023-11-28T11:53:05","modified_gmt":"2023-11-28T11:53:05","slug":"safe-prescribing-of-nsaids","status":"publish","type":"page","link":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/","title":{"rendered":"Safe Prescribing of NSAIDS"},"content":{"rendered":"\n<p>The following CDRC resources are available to support safe NSAID Prescribing.<\/p>\n\n\n\n<h2 class=\"has-text-color wp-block-heading\" style=\"color:#009f98\">Set-up<\/h2>\n\n\n\n<p>Ensure the following protocols are active by going to <strong>Setup  &gt;Workflow Support &gt; Protocol&nbsp;<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"633\" height=\"260\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png\" alt=\"NSAID Aceclofenac Checklist \nNSAID Celecoxib Checklist \nNSAID Checklist (manual start) \nNSAID Diclofenac Checklist \nNSAID Etodolac Checklist \nNSAID Etoricoxib Checklist \nNSAID Flurbiprofen Checklist \nNSAID Generic Checklist \nNSAID Ibuprofen Checklist \nNSAID Indometacin Checklist \nNSAID Ketoprofen Checklist \nNSAID Nabumetone Checklist \nNSAID Naproxen Checklist \nNSAID Piroxicam Checklist \nNSAID Sulindac Checklist \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nOCS \/ Medication \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nZ] \nDCS \nocs \nocs \nocs \nocs \nocs \nocs \nocs \nocs \nocs \nocs \nocs \nocs \nocs \nOCS \" class=\"wp-image-4428\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png 633w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290-300x123.png 300w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290-630x260.png 630w\" sizes=\"(max-width: 633px) 100vw, 633px\" \/><\/figure>\n\n\n\n<div style=\"height:10px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Reports<\/summary><div class=\"gb-accordion-text\">\n<p>A series of reports, found in <strong>CDRC Quality &gt; Rheumatology<\/strong>, are available to support safe prescribing of systemic NSAIDs.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"631\" height=\"201\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-291.png\" alt=\"NSAIO safety 2 \nNSAIO safety 2 \nNSAIO safety 3 \nNSAID safety 7 \nNSAIO \nNSAID \nNSAID \nNSAID \nNSAID \nNSAID \nNSAID \nNSAID \nSafe 1 \nContraindication # \nM: Caution* \n2: Caution -1 # \nNo Obvious Indication # \nSafety 4 \nM: Renal impairment- \nSafety \n2: Risk of renal impairment* \nSafety \n3: Risk of renal impairment -1 # \nSafety Consider Gastroprotection # \nSafety Etoricoxib go or 120 but never had 60mg # \nSafety Very high dose etoricoxib on repeat* \nRegular NSAlDs but not on repeat* \nSafety More than one NSAID# \" class=\"wp-image-4429\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-291.png 631w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-291-300x96.png 300w\" sizes=\"(max-width: 631px) 100vw, 631px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Report Name<\/strong><\/td><td><strong>Patients Returned<\/strong><\/td><\/tr><tr><td>? NSAID Safety 1: Contraindication #<\/td><td>Patients on repeat NSAIDs with a clear contraindication&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 2.1: Caution&nbsp;#<\/td><td>Patients on repeat NSAIDs with a condition suggesting caution is needed&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 2.2: Caution &gt;1 #&nbsp;<\/td><td>Patients on repeat NSAIDs with &gt;1 condition suggesting caution is needed&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 3: No obvious indication&nbsp;#<\/td><td>Patients on repeat NSAIDs without clear indication. Only applies to a small number of NSAIDs such as COX2 inhibitors.&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 4.1: Renal impairment -eGFR &lt;30&nbsp;#<\/td><td>Patients on repeat NSAIDs whose last eGFR was &lt;30&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 4.2: Risk of renal impairment&nbsp;#<\/td><td>Patients on repeat NSAIDs with a risk factor for renal impairment&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 4.3: Risk of renal impairment &gt;1&nbsp;#<\/td><td>Patients on repeat NSAIDs with &gt;1 risk factor for renal impairment&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 5: Consider gastroprotection&nbsp;#<\/td><td>Patients on repeat NSAIDs where presence of risk factors suggests gastroprotection should be considered*&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 6.1: Etoricoxib 90 or 120 but never had 60mg&nbsp;#<\/td><td>Safety report based on MHRA alert that lowest dose of etoricoxib should be used&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 6.2: Very high dose etoricoxib on repeat&nbsp;#<\/td><td>Safety report based on MHRA alert. 120mg dose not licensed for long term use.&nbsp;&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 7: Regular NSAIDs but not on repeat&nbsp;#<\/td><td>Patients who appear to be receiving recurrent acute issues of systemic NSAIDs.&nbsp; Consider adding the NSAIDs to repeat so prescribing can be monitored more systematically.&nbsp;<\/td><\/tr><tr><td>? NSAID Safety 8: More than one NSAID&nbsp;#<\/td><td>Patients on more than one repeat NSAID.&nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>*This is linked to the more comprehensive&nbsp;<a href=\"\/\/d.docs.live.net\/d9ee9bfd984f25ef\/DCS\/Derwentside%20Clinical%20System\" target=\"_blank\" rel=\"noreferrer noopener\">Gastroprotection<\/a>&nbsp;system that covers other relevant medication such as steroids and antiplatelets.&nbsp;<\/p>\n<\/div><\/details><\/div>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion gb-block-accordion\"><details><summary class=\"gb-accordion-title\">NSAIDs Template<\/summary><div class=\"gb-accordion-text\">\n<h3 class=\"wp-block-heading\">How to Access:<\/h3>\n\n\n\n<p>In the lower left hand corner use the search bar, type in &#8216;NSAIDs &#8211; CDRC&#8217; and select the template:<\/p>\n\n\n\n<p>Alternatively, press F12 and search for &#8216;NSAIDs &#8211; CDRC&#8217;, this will open the aforementioned template.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">NSAIDs Template:<\/h3>\n\n\n\n<p>The <strong>NSAID <\/strong>template provides the key information needed to support safe prescribing.&nbsp; An example is shown below from a patient at high risk of complications.&nbsp;There are also:&nbsp;&nbsp;<\/p>\n\n\n\n<ul><li>Links to tabs showing more specific information for individual NSAIDs.&nbsp;<\/li><li>Link to a patient information leaflet&nbsp;<\/li><li>Link to CKS guidelines&nbsp;<\/li><li>Link to BNF section on NSAIDs&nbsp;<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"942\" height=\"654\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-292.png\" alt=\"Aceclofenac \nEtoricoxib \nKetoprofen \nSulindac \nNSAlDs Aceclofenac Celecokib Diclofenac Etodolac \nEtoricokib Flurbiprofen Ibuprofen \nO Print NSAID PILO CKS- NSAIOs \nNaproxen 250mg tablets \nNSAlDs \n! NSAID RISK OF RENAL IMPAIRMENT ! - RENIN ANGIOTENSIN SYSTEM MEDS \nIndometacin Ketoprofen Nabumetone Naproxen \n27 Dec 201g take on... 84 tablet \n! NSAID CONTRAINDICATION \n! NSAID CAUTION(S) \n! RISK FACTOR FOR BLEEDING ! - SUSPECTED PROLONGED NSAID USE \n! RISK FACTOR FOR BLEEDING ! - ON ASPIRIN \n! RISK FACTOR FOR BLEEDING ! - OVER 65 \n! RISK FACTOR FOR BLEEDING ! - HAS CKD3-5 \n! RISK FACTOR FOR BLEEDING ! - HAS CARDIOVASCULAR DISEASE \n! NSAID RISK OF RENAL IMPAIRMENT ! - OVER 75Y \n! NSAID RISK OF RENAL IMPAIRMENT ! - HEART FAILURE \n! NSAID RISK OF RENAL IMPAIRMENT ! - CKD3-5 OR eGFR \n! NSAID RISK OF RENAL IMPAIRMENT ! - ON DIURETICS \nLatest Renal Function \nPirokicam \nSulinda( \nCelecoxib Diclofenac \nNabumetoneNaproxen \nEtodolac \nIndometacin \nPiroxicam \nNSAID Comparison \nBNF - NSAIOs \nGastroprotection for NSAIDs \nNSAID Checklist \nNSAID Scripts in the last year \n04 sep 201g GFR calculated abbreviated MORO rxaK8y) \nLansoprazole 15mg gastro-resistant cam\u201e27 Dec 201g take omn 28 cam\u201e \n53 ml-imin\/1 73m*2 \n02 Jan 2020 06 22 \nNSAID Checklist \nEntered by \nFORBES, Gareth (Dr) (General Medical Practitioner) \nNSAID Checklist \nNSAlD(s) being used \nIndication \nAdvised to take with food \nAdvised to take minimum needed \nRisk of Gl complications discussel \nGastroprotection \nRisk of CVD complications discussed \nRisk of renal complications discussed \nSick day rules discussed \nPIL Issued \nNaproxen \nArlhritis \nYes \nYes \nYes \nRecommended \nYes \nYes \nYes \nYes \" class=\"wp-image-4430\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-292.png 942w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-292-300x208.png 300w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-292-768x533.png 768w\" sizes=\"(max-width: 942px) 100vw, 942px\" \/><\/figure>\n\n\n\n<p>The&nbsp;<strong>NSAID Comparison&nbsp;<\/strong>page provides an overview of the relative risks and benefits of various NSAIDs.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"612\" height=\"444\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-293.png\" alt=\"NSAID Comparison \nEffectiveness \nLess effective \nIbuprofen \nKetoprofen \nModerately Effective \nAceclofenac \nCelecoxib \nDiclofenac \nEtodolac \nEtoricoxib \nNabumetone \nNaproxen \nPiroxicam \nSulindac \nHighly Effective \nFlurbiprofen \nIndometacine \nGl Tolerability \nLower Gl Effects \nIbuprofen \nCelecoxib \nEtoricoxib \nHigher Gl Effects \nFlurbiprofen \nIndometacin \nPiroxicam \nCardiovascular Disease Risk \nLowest risk \nIbuprofen 200mg per day \nNaproxen \nHighest Risk \nCelecoxib \nEtoricoxib \nDiclofenac \" class=\"wp-image-4431\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-293.png 612w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-293-300x218.png 300w\" sizes=\"(max-width: 612px) 100vw, 612px\" \/><\/figure>\n\n\n\n<p>The&nbsp;<strong>Gastroprotection for NSAIDs&nbsp;<\/strong>button is a link to more detailed information to support measures to reduce gastrointestinal adverse reactions.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"943\" height=\"570\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-294.png\" alt=\"NSAlDs \nCKS Guidance \nTo avoid Gl adverse effects try to use the lowest dose for the shortest tim4 \nRisk Factors For NSAID Induced Gl ADRs \n\u2022 Max dose NSAlDs \n\u2022 over 65} \n\u2022 History peptic ulcer, Gl bleeding or perforation \n\u2022 Concomitant drugs that increase Gl bleeding risk \n\u2022 aspirin, steroids, SSRI, duloxetine, venlafaxine and anticoagulants \n\u2022 Comorbidity, cardiovascular disease, hepatic or renal impairment \ndiabetes, hypenensiom \n\u2022 Requirement for prolonged use, including \n\u2022 OA or rheumatoid arthritis at any age \n\u2022 Chronic low back pain over 45 \nAdditional Risk Factors \n\u2022 NSAID type - lowest risk with ibuprofen \n\u2022 Presence of heliocbacter infection \n\u2022 Excessive alcohol use \n\u2022 Heav,'\/ smoking \nRisk Reduction \nNSAID Gastroprotection Information \nNaproxen 250mg tablets \n27 Dec \ntake 84 ta \nLansoprazole 15mg gastro-n 27 Dec \ntake 28 c \n! RISK FACTOR FOR BLEEDING ! - SUSPECTED PROLONGED NSAID USE \n! RISK FACTOR FOR BLEEDING ! - HAS CARDIOVASCULAR DISEASE \n! RISK FACTOR FOR BLEEDING ! - ON ASPIRIN \n! RISK FACTOR FOR BLEEDING ! - OVER 65 \n! RISK FACTOR FOR BLEEDING ! - HAS CKD3-5 \nEx smoker \nAlcohol intake \n0 unitsmeek \n18 sep 201g \nHigh risk \nMod risk \nLow risk \nh\/o complicated ulcer or -2 risk factors \nconsider COX2* and PPI \n1-2 risk factors \nNSAIO and PPI \nNo risk factors \nNSAIO \n*Balance Gl risk against CVD\/hear1 failure risk \" class=\"wp-image-4432\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-294.png 943w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-294-300x181.png 300w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-294-768x464.png 768w\" sizes=\"(max-width: 943px) 100vw, 943px\" \/><\/figure>\n\n\n\n<p>The&nbsp;<strong>NSAID Checklist&nbsp;<\/strong>button runs the NSAID safety protocol and prompts users to complete the safety checklist with the patient &#8211; more details below.&nbsp;<\/p>\n\n\n\n<p>The&nbsp;<strong>NSAID Scripts in the last year&nbsp;<\/strong>button displays all issues of NSAIDs in the last year&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"857\" height=\"285\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-295.png\" alt=\"! NSAID RISK OF RENAL IMPAIRMENT ! - OVER 75Y \nOCS NSAID Issues (last year) \nNSAID Issues \nNaproxen 250mg tablets \nNaproxen 250mg tablets \nNaproxen 250mg tablets \nNaproxen 250mg tablets \nNaproxen 250mg tablets \nNaproxen 250mg tablets \nNaproxen 250mg tablets \nNSAID Checklist \nNSAlD(s) being used \ntake one tablet up to 3 times \ntake one tablet up to 3 times \ntake one tablet up to 3 times \ntake one tablet up to 3 times \ntake one tablet up to 3 times \ntake one tablet up to 3 times \ntake one tablet up to 3 times \nNaproxen \n26 dun 201g \n18 dui 201g \n13 Aug \n11 Oct 201g \n04 Nov \n02 Dec 201g \n27 Dec 201g \" class=\"wp-image-4433\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-295.png 857w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-295-300x100.png 300w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-295-768x255.png 768w\" sizes=\"(max-width: 857px) 100vw, 857px\" \/><\/figure>\n<\/div><\/details><\/div>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion gb-block-accordion\"><details><summary class=\"gb-accordion-title\">NSAIDs Checklist<\/summary><div class=\"gb-accordion-text\">\n<p>The NSAID checklist is a protocol that runs a series of checks and provides warnings to support safe NSAID prescribing. The checklist can be triggered in the following ways:&nbsp;<\/p>\n\n\n\n<ul><li>By clicking the&nbsp;<em>NSAID Checklist&nbsp;<\/em>button on the NSAID template&nbsp;<\/li><li>By adding the protocol to one of your own toolbars&nbsp;<\/li><li>(If activated at the practice) Will launch automatically if:&nbsp;<ul><li>An NSAID is added to repeat medication OR&nbsp;<\/li><li>An NSAID is prescribed for the first time in the last 12 months&nbsp;<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>The protocol runs the following checks:&nbsp;<\/p>\n\n\n\n<ul><li>Are there contraindications to NSAID use e.g. celecoxib and previous stroke?&nbsp;<\/li><li>Are there issues that suggest caution is needed?&nbsp;<\/li><li>For certain drugs (such as COX2 inhibitors) is there a clear licensed indication?&nbsp;<\/li><li>Is more than one NSAID being used?&nbsp;<\/li><li>Are there risk factors for GI adverse reactions and is gastroprotection being prescribed?&nbsp;<\/li><li>Are there risk factors for renal impairment?&nbsp;<\/li><\/ul>\n\n\n\n<p>Each warning is accompanied by a link to the NSAID template so the relevant issues can be seen in more detail.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"655\" height=\"375\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-299.png\" alt=\"Question \nThis patient appears to have more than one condition suggesting diclotenac should \nonly be used with caution \nLiew Cautions \nContinue Anyway \nClose \nPause \" class=\"wp-image-4437\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-299.png 655w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-299-300x172.png 300w\" sizes=\"(max-width: 655px) 100vw, 655px\" \/><\/figure>\n\n\n\n<p>The protocol provides recommendations on monitoring that may be required such as follow up blood pressure, renal and anaemia testing&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"551\" height=\"244\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-296.png\" alt=\"Question \nIf long term use proposed, check BP 2w after starting \" class=\"wp-image-4434\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-296.png 551w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-296-300x133.png 300w\" sizes=\"(max-width: 551px) 100vw, 551px\" \/><\/figure>\n\n\n\n<p>Finally the protocol offers a link to a checklist to run through with the patient.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"582\" height=\"384\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-297.png\" alt=\"Question \nComplete NSAID Checklist? \nQpen Template To Check For Previous Checklists \nClose \nPause \" class=\"wp-image-4435\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-297.png 582w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-297-300x198.png 300w\" sizes=\"(max-width: 582px) 100vw, 582px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"667\" src=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-298-1024x667.png\" alt=\"NSAID Checklist \nO Yes \nO No \nO Not known \nAdvised to take minimum needed \nO Yes \nO No \nO Not known \nRisk of Gl complications discussed \nO Yes \nO No \nO Not known \nGastroprotection \nO Recommended \nO Not indicated \nO Not discussed \nO No information \nRisk ofCVD complications discussed \nO Yes \nO No \nO Not known \nRisk of renal complications discussed \nO Yes \nO No \nO Not known \" class=\"wp-image-4436\" srcset=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-298-1024x667.png 1024w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-298-300x195.png 300w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-298-768x500.png 768w, https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-298.png 1044w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>Once completed, information from the checklist is displayed on the NSAID Template.&nbsp;<\/p>\n<\/div><\/details><\/div>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion gb-block-accordion\"><details><summary class=\"gb-accordion-title\">NSAIDs Monitoring<\/summary><div class=\"gb-accordion-text\">\n<p>The CDRC Drugs Requiring Monitoring system includes 12 monthly renal function monitoring for patients on repeat NSAIDs if they have at least one risk factor for renal impairment.&nbsp; An additional six monthly check is prompted by the system if more than one risk factor is present.&nbsp;<\/p>\n<\/div><\/details><\/div>\n","protected":false},"excerpt":{"rendered":"<p>The following CDRC resources are available to support safe NSAID Prescribing. Set-up Ensure the following protocols are active by going to Setup &gt;Workflow Support &gt; Protocol&nbsp;<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":5360,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Safe Prescribing of NSAIDS - Clinical Digital Resource Collaborative<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Safe Prescribing of NSAIDS - Clinical Digital Resource Collaborative\" \/>\n<meta property=\"og:description\" content=\"The following CDRC resources are available to support safe NSAID Prescribing. Set-up Ensure the following protocols are active by going to Setup &gt;Workflow Support &gt; Protocol&nbsp;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/\" \/>\n<meta property=\"og:site_name\" content=\"Clinical Digital Resource Collaborative\" \/>\n<meta property=\"article:modified_time\" content=\"2023-11-28T11:53:05+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/\",\"url\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/\",\"name\":\"Safe Prescribing of NSAIDS - Clinical Digital Resource Collaborative\",\"isPartOf\":{\"@id\":\"https:\/\/cdrc.nhs.uk\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png\",\"datePublished\":\"2022-10-07T14:40:42+00:00\",\"dateModified\":\"2023-11-28T11:53:05+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#breadcrumb\"},\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-GB\",\"@id\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#primaryimage\",\"url\":\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png\",\"contentUrl\":\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png\",\"width\":633,\"height\":260},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/cdrc.nhs.uk\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Resources\",\"item\":\"https:\/\/cdrc.nhs.uk\/resources\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"SystmOne Resource Centre\",\"item\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Medicine Management\",\"item\":\"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Safe Prescribing of NSAIDS\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/cdrc.nhs.uk\/#website\",\"url\":\"https:\/\/cdrc.nhs.uk\/\",\"name\":\"Clinical Digital Resource Collaborative\",\"description\":\"Designed and developed in the North East and North Cumbria by local GPs\",\"publisher\":{\"@id\":\"https:\/\/cdrc.nhs.uk\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/cdrc.nhs.uk\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-GB\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/cdrc.nhs.uk\/#organization\",\"name\":\"Clinical Digital Resource Collaborative\",\"url\":\"https:\/\/cdrc.nhs.uk\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-GB\",\"@id\":\"https:\/\/cdrc.nhs.uk\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2020\/05\/CDRC-Logo-1.png\",\"contentUrl\":\"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2020\/05\/CDRC-Logo-1.png\",\"width\":777,\"height\":104,\"caption\":\"Clinical Digital Resource Collaborative\"},\"image\":{\"@id\":\"https:\/\/cdrc.nhs.uk\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Safe Prescribing of NSAIDS - Clinical Digital Resource Collaborative","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/","og_locale":"en_GB","og_type":"article","og_title":"Safe Prescribing of NSAIDS - Clinical Digital Resource Collaborative","og_description":"The following CDRC resources are available to support safe NSAID Prescribing. Set-up Ensure the following protocols are active by going to Setup &gt;Workflow Support &gt; Protocol&nbsp;","og_url":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/","og_site_name":"Clinical Digital Resource Collaborative","article_modified_time":"2023-11-28T11:53:05+00:00","og_image":[{"url":"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png"}],"twitter_card":"summary_large_image","twitter_misc":{"Estimated reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/","url":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/","name":"Safe Prescribing of NSAIDS - Clinical Digital Resource Collaborative","isPartOf":{"@id":"https:\/\/cdrc.nhs.uk\/#website"},"primaryImageOfPage":{"@id":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#primaryimage"},"image":{"@id":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#primaryimage"},"thumbnailUrl":"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png","datePublished":"2022-10-07T14:40:42+00:00","dateModified":"2023-11-28T11:53:05+00:00","breadcrumb":{"@id":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#breadcrumb"},"inLanguage":"en-GB","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/"]}]},{"@type":"ImageObject","inLanguage":"en-GB","@id":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#primaryimage","url":"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png","contentUrl":"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2022\/09\/image-290.png","width":633,"height":260},{"@type":"BreadcrumbList","@id":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/safe-prescribing-of-nsaids\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/cdrc.nhs.uk\/"},{"@type":"ListItem","position":2,"name":"Resources","item":"https:\/\/cdrc.nhs.uk\/resources\/"},{"@type":"ListItem","position":3,"name":"SystmOne Resource Centre","item":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/"},{"@type":"ListItem","position":4,"name":"Medicine Management","item":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/medicine-management\/"},{"@type":"ListItem","position":5,"name":"Safe Prescribing of NSAIDS"}]},{"@type":"WebSite","@id":"https:\/\/cdrc.nhs.uk\/#website","url":"https:\/\/cdrc.nhs.uk\/","name":"Clinical Digital Resource Collaborative","description":"Designed and developed in the North East and North Cumbria by local GPs","publisher":{"@id":"https:\/\/cdrc.nhs.uk\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/cdrc.nhs.uk\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-GB"},{"@type":"Organization","@id":"https:\/\/cdrc.nhs.uk\/#organization","name":"Clinical Digital Resource Collaborative","url":"https:\/\/cdrc.nhs.uk\/","logo":{"@type":"ImageObject","inLanguage":"en-GB","@id":"https:\/\/cdrc.nhs.uk\/#\/schema\/logo\/image\/","url":"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2020\/05\/CDRC-Logo-1.png","contentUrl":"https:\/\/cdrc.nhs.uk\/wp-content\/uploads\/2020\/05\/CDRC-Logo-1.png","width":777,"height":104,"caption":"Clinical Digital Resource Collaborative"},"image":{"@id":"https:\/\/cdrc.nhs.uk\/#\/schema\/logo\/image\/"}}]}},"featured_image_src":null,"featured_image_src_square":null,"_links":{"self":[{"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/pages\/4427"}],"collection":[{"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/comments?post=4427"}],"version-history":[{"count":0,"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/pages\/4427\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/pages\/5360"}],"wp:attachment":[{"href":"https:\/\/cdrc.nhs.uk\/wp-json\/wp\/v2\/media?parent=4427"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}