{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:30:12Z","timestamp":1791646212855,"version":"4.3.4"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Virginia Tech Libraries"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Professional guidelines advise against regular or long-term NSAID use in most patients with chronic kidney disease (CKD), heart failure (HF), and hypertension (HTN) due to risk of adverse events. Nevertheless, over-the-counter (OTC) NSAIDs are broadly accessible and frequently used among this population. Efforts to decrease high-risk OTC NSAID use have the potential to improve safety and reduce chronic disease burden. This randomized controlled trial evaluated the effectiveness of a brief, electronically-administered educational video in reducing high-risk OTC NSAID use. Adult participants with CKD, HF, and\/or HTN who self-identified as regular NSAID users (\u22653 times\/week for 3 months) were invited to participate. Participants (n\u2009=\u2009425) were randomized to either view an electronically-administered educational video informed by the COM-B behavioral change model (VIDEO, n\u2009=\u2009223) or the FDA Drug Facts label for NSAIDs (CONTROL, n\u2009=\u2009202). Intent to decrease OTC NSAIDs was evaluated via 11-point contemplation ladder immediately and 4 weeks post-intervention, with self-reported NSAID Exposure assessed at 4 weeks. We also evaluated current and recent pain levels at baseline and 4 weeks. Intent to decrease OTC NSAID use (4.28 (SD: 3.45) ladder rungs) and NSAID exposure (20.14 (SD: 13.66) dose-days per month) did not differ between groups at baseline. Intent to decrease OTC NSAID use increased more from baseline to immediately post-intervention in VIDEO vs. CONTROL (1.32 (SD: 2.80) vs. 0.55 (SD: 1.99) rungs, p\u2009&lt;\u20090.001), with greater improvements for those with lower baseline intent. VIDEO and CONTROL were associated with a similar rise in intent to decrease OTC NSAID use (1.92 (SD: 4.41) vs. 1.36 (SD: 3.46), p\u2009=\u20090.150) and a similar decrease in NSAIDs exposure (\u221232.8% in VIDEO and \u221236.5% in CONTROL, p\u2009=\u20090.520) 4 weeks post-intervention. Pain levels did not differ between groups. Results suggest that a low-burden, electronically-administered intervention reduce high-risk medication use among patients with CKD, HF, and\/or HTN.<\/jats:p>","DOI":"10.1371\/journal.pone.0323582","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T18:34:11Z","timestamp":1762799651000},"page":"e0323582","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["A brief, theory-driven patient education video reduces high-risk over-the-counter nonsteroidal anti-inflammatory drug (NSAID) use"],"prefix":"10.1371","volume":"20","author":[{"given":"Matthew G.","family":"Vinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison N.","family":"Tegge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8294-6856","authenticated-orcid":true,"given":"Mamata R.","family":"Tokala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara R.","family":"Spivey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha M.","family":"Tenzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Epling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7910-6083","authenticated-orcid":true,"given":"Michelle S.","family":"Rockwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"issue":"10","key":"pone.0323582.ref001","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1007\/s00228-014-1734-6","article-title":"Non-steroidal anti-inflammatory drug use in chronic pain conditions with special emphasis on the elderly and patients with relevant comorbidities: management and mitigation of risks and adverse effects","volume":"70","author":"M Wehling","year":"2014","journal-title":"Eur J Clin Pharmacol"},{"issue":"1","key":"pone.0323582.ref002","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s42506-018-0005-2","article-title":"Non-steroidal anti-inflammatory drugs among chronic kidney disease patients: an epidemiological study","volume":"94","author":"S Abd ElHafeez","year":"2019","journal-title":"J Egypt Public Health Assoc"},{"issue":"4","key":"pone.0323582.ref003","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1053\/j.ajkd.2020.03.023","article-title":"NSAIDs in CKD: are they safe?","volume":"76","author":"M Baker","year":"2020","journal-title":"Am J Kidney Dis"},{"issue":"6","key":"pone.0323582.ref004","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: a Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"PK Whelton","year":"2018","journal-title":"Hypertension"},{"issue":"1","key":"pone.0323582.ref005","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2016-000550","article-title":"Use of non-steroidal anti-inflammatory drugs in US adults: changes over time and by demographic","volume":"4","author":"JS Davis","year":"2017","journal-title":"Open Heart"},{"issue":"1","key":"pone.0323582.ref006","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/pds.3463","article-title":"Trends in the use of aspirin and nonsteroidal anti-inflammatory drugs in the general U.S. population","volume":"23","author":"Y Zhou","year":"2014","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"645","key":"pone.0323582.ref007","doi-asserted-by":"crossref","first-page":"172","DOI":"10.3399\/bjgp16X684433","article-title":"The dangers of NSAIDs: look both ways","volume":"66","author":"A Davis","year":"2016","journal-title":"Br J Gen Pract"},{"key":"pone.0323582.ref008","unstructured":"ASN - Avoid nonsteroidal anti-inflammatory drug use | Choosing Wisely. 2012. 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