Author Credentials

Courtney D. Wellman, MD Jordan Ratcliffe, BS William Rollyson, MD Adam M. Franks, MD Mike Grome, PA-C Robert Walker, MD

Author ORCID Identifier

Courtney D. Wellman, MD (ORCID# 0000-0001-5425-3415)

Adam M. Franks, MD (ORCID# 0000-0002-3710-6138)


Older Adults, Analgesics, NSAID, Appalachian


Family Medicine | Geriatrics | Medicine and Health Sciences | Primary Care



Over-the-counter (OTC) medications are commonly used by elderly patients to self-manage pain symptoms. Medications such as non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen and topical analgesics are readily available and therefore may seem harmless to patients. In the growing population of those 65 years and older, providers need to inquire about OTC medication use due to the increased risk for adverse reactions in this population. Complications related to these medications can be worsened by chronic disease, variable metabolism, polypharmacy, etc. which become more common in the older adults.


A survey was created to determine the prevalence and habits of OTC use in the central Appalachian population, as well as the potential harms involved related to provider awareness, chronic disease, and polypharmacy.


Of surveyed Appalachian seniors (n = 307), 86.3% take OTC medications. Of these, 57.4% report that they do not tell their provider and 51.3% do not take the medication as directed. Within this population, 19.2% of those on blood thinners, 22.4% of those with hypertension, 34.8% of those with chronic kidney disease, and 30.6% of those with gastrointestinal issues are not only using NSAIDs but also do not inform their physician nor follow the packaging instructions.


Potential complications of NSAID use related to these medical comorbidities are well known. Providers need to regularly ask their older adult patients about the use of OTC medication to prevent adverse events in this vulnerable population.