Trends and Disparities in High-Risk Nonsteroidal Anti-Inflammatory Drug Utilization.
MS, R., C, G., JK, T., M, V., I, Y., AL, H., & JW, E. (2026). Trends and Disparities in High-Risk Nonsteroidal Anti-Inflammatory Drug Utilization.. The American journal of managed care. https://doi.org/10.37765/ajmc.2026.90002
MS R, C G, JK T, M V, I Y, AL H, et al. Trends and Disparities in High-Risk Nonsteroidal Anti-Inflammatory Drug Utilization.. The American journal of managed care. 2026; doi: 10.37765/ajmc.2026.90002
MS R, C G, JK T, et al. Trends and Disparities in High-Risk Nonsteroidal Anti-Inflammatory Drug Utilization.[J]. The American journal of managed care. 2026. DOI: 10.37765/ajmc.2026.90002.
@article{ms2026,
author = {Rockwell MS and Grubb C and Turner JK and Vinson M and Yim I and Hanlon AL and Epling JW},
title = {Trends and Disparities in High-Risk Nonsteroidal Anti-Inflammatory Drug Utilization.},
journal = {The American journal of managed care},
year = {2026},
doi = {10.37765/ajmc.2026.90002},
note = {PMID: 42663549},
}
TY - JOUR AU - Rockwell MS AU - Grubb C AU - Turner JK AU - Vinson M AU - Yim I AU - Hanlon AL AU - Epling JW TI - Trends and Disparities in High-Risk Nonsteroidal Anti-Inflammatory Drug Utilization. T2 - The American journal of managed care PY - 2026 DO - 10.37765/ajmc.2026.90002 AN - PMID:42663549 ER -
OBJECTIVES: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) poses a risk to patients with chronic kidney disease (CKD), heart failure (HF), and hypertension (HTN). We evaluated changes in NSAID utilization among a large cohort of Virginia patients with CKD, HF, and/or HTN during the COVID-19 pandemic and assessed variation by patient demographic characteristics. STUDY DESIGN: Quasi-experimental difference-in-differences approach. METHODS: Using claims from the Virginia All-Payer Claims Database, we identified NSAID prescriptions dispensed to patients with CKD, HF, and/or HTN during the years 2019-2021. We applied Poisson regression to assess the impact of the COVID-19 pandemic (March 1, 2020- December 31, 2021) on NSAID utilization rates, stratifying incidence rate ratios (IRRs) by rurality, sex, and age. RESULTS: Extrapolated to the statewide population, approximately 3.8 million NSAID prescriptions were dispensed to Virginians with CKD, HF, and/or HTN between 2019 and 2021. Utilization rates declined by 23% during the first 2 years of the pandemic, were greater in rural vs urban areas (IRR, 1.594; 95% CI, 1.408-1.803) and among those aged 40 to 64 years, 65 to 79 years, and 80 years and older vs those aged 18 to 39 years (40-64 years: IRR, 6.366; 95% CI, 5.979-6.778; 65-79 years: IRR, 6.980; 95% CI, 6.568-7.417; ≥ 80 years: IRR, 5.223; 95% CI, 4.772-5.715); and were lower among men than women (IRR, 0.779; 95% CI, 0.758-0.800). The pandemic impacted rural and urban areas and women and men similarly but was associated with lower NSAID utilization among the 3 older age groups vs those aged 18 to 39 years (40-64 years: IRR, 0.869; 95% CI, 0.812-0.931; 65-79 years: IRR, 0.788; 95% CI, 0.733-0.847; ≥ 80 years: IRR, 0.769; 95% CI, 0.709-0.833). CONCLUSIONS: Despite a modest decline during the first 2 years of the pandemic, NSAID use remains prevalent among patients with CKD, HF, and/or HTN, especially in rural areas and among women. Results highlight the need for tailored deprescribing efforts.