The role of a pharmacist in screening, communicating and reporting the risks of cardiovascular disease associated with non-steroidal anti-inflammatory drugs and the perception of the population

Cardiovascular disease (CVD) continues to be the foremost cause of mortality globally, with a substantial burden observed in the United Kingdom (UK). Despite public health initiatives and advances in clinical management, gaps in public awareness, risk perception, and medication safety, particularly concerning non-steroidal anti-inflammatory drugs (NSAIDs), pose significant challenges to effective prevention and self-management strategies. This thesis adopts a mixed-methods approach to examine three interrelated dimensions of this issue: public knowledge of NSAID-related CVD risks, pharmacists’ roles in mitigating these risks, and public perceptions of access to pharmacy-led healthcare services. A cross-sectional survey of 228 UK adults assessed knowledge, perceptions, and behaviours regarding NSAID use and associated cardiovascular risks. Findings demonstrated a high prevalence of NSAID consumption, widespread lack of awareness of associated CVD risks, and significant demographic disparities in health literacy. Although participants acknowledged the importance of lifestyle factors in CVD prevention, confidence in specific risk reduction strategies and awareness of pharmacological hazards remained low. In parallel, a national survey of 114 pharmacists identified inconsistent practices in patient risk screening and communication of NSAID-associated adverse effects, with myocardial infarction and stroke being among the least discussed risks. Furthermore, limited engagement with the Yellow Card Scheme and a lack of formal training in adverse drug reaction (ADR) reporting highlighted systemic barriers to effective pharmacovigilance. To further contextualise these findings, qualitative interviews with members of the public explored perceptions of community pharmacy services. Thematic analysis identified four primary barriers: limited public awareness of pharmacists’ clinical roles, reduced confidence in their expertise, structural and communicative obstacles within pharmacy environments, and concerns about privacy. These factors collectively hinder optimal utilisation of pharmacist-led healthcare. This research highlights critical deficiencies in both public understanding and professional practices related to NSAID safety and CVD prevention. It emphasises the urgent need for integrated, multi-level interventions, encompassing public health education, professional training, and systemic reform to enhance patient safety, promote appropriate NSAID use, and optimise the role of pharmacists in cardiovascular risk management.

Name dc:type.qualificationname

PhD

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

De Montfort University

Year dc:date.issued

2025

Author dc:creator

• Ali, Koddus

Licence

• https://dora.dmu.ac.uk/bitstreams/f3175e6f-603d-4689-a1c2-ffcde15db4fc/download