Evaluation of family physicians' knowledge, attitudes, and practices regarding non-steroidal anti-inflammatory drugs

Evaluatıon Of Famıly Physıcıans' Knowledge, Attıtudes, And Practıces Regardıng Non-Steroıdal Antı-Inflammatory Drugs Introduction: Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are widely used both globally and in our country. The aim of this study is to evaluate the knowledge, attitudes, and behaviors of family physicians working at different levels regarding non-steroidal anti-inflammatory drugs. Materials and Method: This cross-sectional, analytical study was conducted in 2025 by the Department of Family Medicine at Malatya İnönü University. The study population consisted of family physicians working in Malatya, including those affiliated with the Malatya Provincial Health Directorate and research assistants at İnönü University Faculty of Medicine, Department of Family Medicine. A total of 227 family physicians were reached. Data collection was conducted face-to-face using forms developed by the researchers to assess attitudes, behaviors, and knowledge levels related to NSAIDs. Results: The mean age of the 227 physicians included in the study was 43.77±10.63 years (min: 25 – max: 69). Of these physicians, 62.6% (n=142) were male, and 37.4% (n=85) were female. About 23.3% of the family physicians had received in-service training on NSAIDs. The most important factors influencing NSAID prescription among family physicians were the clinical efficacy of the drug, side effect profile of the drug and its route of administration, and pharmaceutical form. The most frequently preferred route for NSAID administration was enteral-oral. The most commonly prescribed NSAID drug group was propionic acid derivatives (Profen group). The most frequently prescribed NSAID active ingredients were paracetamol, dexketoprofen, ibuprofen, and diclofenac. There were no significant differences in knowledge levels based on physicians' professional titles regarding the lethal dose of aspirin, maximum daily analgesic dose of aspirin, ulcer localization caused by aspirin and other NSAIDs, tinnitus and hearing loss in salicylate intoxication, glycemic changes in children with salicylate intoxication, and knowledge related to paracetamol intoxication. However, knowledge levels were significantly higher among Family Medicine Specialists(FMS) and research assistants regarding the comparison of anti-inflammatory effects between NSAIDs and glucocorticoids, comparison of analgesic efficacy between NSAIDs and narcotic analgesics, lack of addiction potential in NSAIDs, reversible/irreversible inhibition of cyclooxygenase(COX) enzymes, timing of NSAID use in patients on antiaggregant therapy with aspirin, dosage required for analgesic and anti-inflammatory efficacy of ibuprofen, NSAID-corticosteroid/SSRI(Selective Serotonin Reuptake İnhibitor) interactions, ibuprofen-digoxin interactions, use of enteric-coated forms to minimize GI(Gastrointestinal) irritation, taking NSAIDs with food, with milk, or with a large glass of water (at least one glass), and the recommendation of gastroprotective drugs for NSAID users. Conclusion: Family physicians most frequently consider drug efficacy when prescribing NSAIDs. Physicians with fewer years of professional experience had higher knowledge levels about NSAIDs. It is recommended to increase NSAID-related education during family medicine residency training and to provide in-service training to physicians with over 15 years of professional experience. Keywords: Family physician, Rational drug use, Analgesic, NSAIDs