Options for local implementation
Review the appropriateness of non-steroidal anti-inflammatory drug (NSAID) prescribing widely and on a routine basis, especially in people who are at higher risk of gastrointestinal, renal and cardiovascular morbidity and mortality (for example, older people).
If an NSAID is needed, use ibuprofen (1,200 mg a day or less) or naproxen (1,000 mg a day or less). Use the lowest effective dose and the shortest duration of treatment necessary to control symptoms.
Co-prescribe a proton pump inhibitor with NSAIDs for people who have osteoarthritis or rheumatoid arthritis, and think about the use of gastroprotective treatment when prescribing NSAIDs for low back pain, axial spondyloarthritis, psoriatic arthritis and other peripheral spondyloarthritides.