Facing the Side Effects: Patient-Reported Adverse Outcomes of NSAIDs for Chronic Pain Management in North India

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are widely used for pain and inflammation relief and are available over the counter in India. Despite common adverse drug events (ADEs), formal reporting and patient awareness remain low. This cross-sectional study in a primary care facility in Haridwar, Uttarakhand, assessed 201 patients aged 18 to 75 years using NSAIDs for at least three months for chronic pain. A structured de novo questionnaire (Cronbach's α 0.85) evaluated their knowledge, attitude, practices (KAP), risk factors, and self-reported ADEs. Results showed 47% lacked NSAID knowledge, 66% held negative attitudes, and 55% did not comply with prescriptions. Around 63% were at risk of complications, and 67% experienced ADEs. Most (68%) wanted to stop NSAIDs, while 58% favored alternative therapies for pain management. The study revealed limited awareness of NSAID risks in this region, with many experiencing ADEs and at risk of complications. The findings highlight the urgent need for educational programs and revisiting current NSAID usage guidelines to prevent ADEs and promote safer alternatives in India.