Beyond Pain Relief: A Cross-Sectional Study on NSAID Prescribing, Polypharmacy, and Drug Interaction Risks in Community Pharmacies

Abstract

Highlights: What are the main findings? Celecoxib and ketoprofen were the most commonly prescribed NSAIDs in community pharmacies, while polypharmacy and potential drug–drug interactions (pDDIs) were highly prevalent. A significant association (p < 0.05) was found between ibuprofen, diclofenac, aspirin, meloxicam use, and the lack of gastroprotective co-prescription, indicating a need for improved adherence to safety guidelines. What are the implications of the main findings? Reinforcing regulatory frameworks and fortifying medication-use policies, combined with pharmacist-led medication review and continuous monitoring, can mitigate NSAID-related risks. The findings provide evidence to inform rational prescribing strategies, strengthen community pharmacy practice, and enhance patient medication safety in the Ras Al Khaimah, one of the Northern Emirates of the United Arab Emirates and similar healthcare settings. Background/Objectives: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used globally to manage pain and inflammation. The rising prevalence of polypharmacy and potential drug–drug interactions (pDDIs) magnified by the prolonged and irrational use of NSAIDs may jeopardize patient medication safety. This study aims to analyze the pattern in prescribing NSAIDs and assess the extent of polypharmacy and pDDIs in community pharmacies located in Ras Al Khaimah. Methods: A quantitative cross-sectional study was conducted in randomly selected community pharmacies over six months (July 2024 to December 2024). Prescriptions pertaining to NSAIDs were assessed for prescribing patterns; incidence of polypharmacy and pDDIs were identified using Lexicomp’s drug interaction database. Chi-square tests assessed associations between treatment variables and polypharmacy, while logistic regression explored predictors of pDDIs. Results: In a total of 600 prescriptions, 1865 drugs were prescribed, including 908 NSAIDs. Celecoxib (28.2%) and ketoprofen (27.6%) remained the most predominant oral and topical NSAIDs prescribed. Aspirin and celecoxib were most commonly linked with pDDIs. A total of 357 pDDIs were identified, averaging 1.87 ± 1.39 per prescription. Most were of minor severity (60.22%), risk category C (43.97%), and fair reliability (59.38%). Gender, nationality, and comorbidities were significantly associated with polypharmacy (p < 0.001). Logistic regression showed nationality (p = 0.016), comorbidities (p < 0.001), and drug count (p = 0.007) as key predictors of pDDIs. Conclusions: Frequent NSAIDs prescribing, incidence of polypharmacy, and pDDIs underscore the attention for more cautious, evidence-based prescribing practice. Enforcing a robust regulatory framework, coupled with strengthening medication-use policies and pharmacist-led thorough medication history review and ongoing monitoring is paramount to improve patient safety and clinical outcomes.