Assessing the benefits and risks of drugs. The example of NSAIDs

Although NSAIDs are among the most familiar drugs to general practitioners, an assessment of their likely benefits and risks should be made for every prescription. The most important risk factors for 'predictable' reactions are old age and a history of peptic ulcer, cardiovascular and renal disease, and asthma. The presence of uncomplicated peptic ulcer is not an absolute contraindication to an NSAID so long as the use of the drug is necessary. These drugs reduce symptoms rather than modify diseases and patients should be involved in the prescribing decision and be empowered to stop treatment.