A Study of Prescription Pattern of Non Steroidal Anti-Inflammatory Drugs in Medicine Out-Patient Clinic of a Rural Teaching Hospital

Abstract

Non Steroidal anti-inflammatory Drugs (NSAIDs) are most commonly prescribed drugs constituting more than 20% of all drug prescriptions. Prescription pattern study of NSAID was conducted in Medicine OPD of a rural teaching hospital with the objective of analyzing prescribing trend of NSAIDs, to evaluate co-prescription of Gastro-protective agents (GPAs) with NSAIDs and to determine number of prescribed NSAIDs falling within Drug utilization (DU) 90% segment. Overall 200 NSAID prescriptions were analysed. Prevalence of NSAID prescription was 25.71%. Paracetamol (36%) was the commonest drug prescribed. In general non-selective NSAIDs were more commonly prescribed (79.5%) and selective COX-2 inhibitors were least prescribed (1%). High prevalence of nimesulide prescription (19.5%) was a significant finding. Co-prescription of GPAs was high (61%). Four drugs (paracetamol, diclofenac, nimesulide and aceclofenac) fall within DU90% segment. In general prescription pattern requires further rationalization of NSAID usage as more number of drugs constitutes DU90% segment.

A Study of Prescribing Patterns for Non-Steroidal Anti-Inflammatory Drugs in a Tertiary Care Teaching Hospital

“…Consistent with results observed in earlier studies, the current study revealed that the most commonly prescribed NSAID was non-selective COX 1 inhibitors [9,10,18,19,20] i.e. A limitation of this study is that the sample was selected using a non-random sampling method, and this may have resulted in a biased sample as the intended population did not have equal sampling probability.…”

Assessment of Nonsteroidal Anti-inflammatory Drugs Prescription Pattern and Gastrointestinal Risk Factors in a Tertiary Care Hospital of Western Nepal

“…On evaluating the duration of therapy it was seen that 178 (48.1%) of the prescription the drug was prescribed up to 4-7 days. From other studies diclofenac sodium, meloxicam, paracetamol and ibuprofen were the commonly prescribed drugs, however dose was not mention on each of the study 2,3,4,13,16,17 it might be due to less side effects from the non-selective group or may be less knowledge over safety of COX-2 selective inhibitors over non-selective group.…”

“…In case of frequency of FDCs so prescribed in the study was found to be 28.37% which is much lower when comparing with the study conducted in Chitwan Medical College (49.61%) 6 , in case of other country combination of NSAID with other drug was more preferred than combination with paracetamol but on the contrary in this study such combination was the most common one rather than with other drugs. However other drugs like antihistaminic, skeletal muscle relaxant and serritopeptidase were also prescribed but as in co-prescribing form 4,10,17 .…”

“…Various randomized studied concluded that importance of co-prescribing GPAswith NSAID, especially with nonselective NSAID 4,6 . Similar trends was also observed in study conducted in Bangalore (72.83%) and two different study conducted in Spain 64% and 85% respectively 4 . In this study rabeprazole followed by pantoprazole sodium sesquihydrate were the most prescribed proton pump inhibitor.…”

“…15 With the introduction of the selective COX-2 inhibitors the prescription pattern of NSAIDs changed frequently over a period of time. 4,17 In addition, Age > 65 years -History of PUD or UGI bleeding, concomitant oral glucocorticoids, Concomitant anticoagulants, Smoking -Alcohol consumption these factors are the major things that need to be considered while prescribing NSAIDs. Therefore, it become very important to evaluate the prescribing pattern of NSAIDs, cost per prescription, co-prescribing pattern of Gastro protective agents with NSAIDs, knowledge of patient towards use of NSAIDs and association of gastrointestinal risk factors with prescribed NSAIDs for the enhancement of rational drug prescribing.…”