# Physical Therapists’ Practices and Attitudes Toward Non-Steroidal Anti-Inflammatory Drugs: A National Cross-Sectional Study

## TL;DR

This study explores how Saudi physical therapists use and discuss NSAIDs, finding inconsistent practices and a need for better guidelines and education.

## Contribution

The study provides new insights into Saudi PTs' NSAID-related practices and attitudes, identifying gaps in knowledge and policy.

## Key findings

- Over half of PTs frequently discuss NSAID use with patients, especially over-the-counter formulations.
- Only 14.6% of PTs reported having institutional policies on NSAID discussions.
- Most PTs (62%) believe they lack adequate knowledge to provide safe medication advice.

## Abstract

Background: Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly used to manage acute or moderate-to-severe musculoskeletal pain. Physical Therapists (PTs) are involved in patient management from early on, providing education and advice related to medication use. This study aimed to examine Saudi PTs’ practice patterns and attitudes toward NSAID use and to identify factors associated with key practice outcomes by discussing NSAID use, assessing contraindications, monitoring side effects, and documenting discussions. Methods: A cross-sectional study was conducted between February and June 2025. A total of 371 PTs (52.3% male) from all regions of the country participated. Data were collected using an expert-reviewed and pilot-tested self-administered questionnaire. Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. Qualitative responses to an open-ended question were analyzed thematically. Results: Over half of PTs (59%) reported frequently discussing NSAID use with patients, particularly over-the-counter topical or oral formulations. Nearly half (48.0%) reported the absence of a formal institutional policy on NSAID discussions, while only 14.6% reported the presence of such policies. Safety practices were inconsistently applied: 46% reported screening for contraindications and 29% monitored potential long-term adverse effects (p < 0.001). Greater involvement in NSAID-related practices was associated with male gender, longer clinical experience, and specialist qualifications. Although 38% supported granting PTs hypothetical prescribing authority, 62% believed they lack adequate knowledge to provide safe and evidence-based medication advice. Conclusions: The study highlights the need for improved pharmacology education, clear national guidelines, and enhanced interprofessional collaboration to promote safe and consistent NSAID use in musculoskeletal care.