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

Abstract

NSAIDs are commonly prescribed group of drugs with changing frequency of prescription pattern over a period of time and has wide range of adverse effect, mainly on alteration in GI, renal functions and CVS system, which can be life-threatening. Thus, the aim of study was to evaluate the current prescription pattern of non-steroidal anti-inflammatory drugs (NSAIDs) and the prevalence of NSAID-induced gastrointestinal (GI) risk factors in a Tertiary Care Hospital of Western Nepal. A prospective observational NSAIDs induced gastrointestinal risk related study was conducted over a period of two months by clinical pharmacist on which study cohort include 370 patients who are taking or/and prescribed with NSAIDs. A self-administered questionnaire was completed by each patient for knowledge over prescribed NSAID and simplified risk scoring scale (the Standardized Calculator of Risk for Events; SCORE) was used to evaluate patients risk for GI complications with the used of NSAIDs. Data were analyzed by using Statistical Package for Social Science (SPSS) software version 17.0. The study groups were stratified into four risk groups according to GI SCORE tool, 18.4% of the patients belonged to high risk to very high risk groups for gastrointestinal complications. Analysis of prescription pattern revealed that overall frequency of prescription pattern of plain NSAIDs was found to be 60%, among which naproxen 500mg (21.3%) was found to be the most commonly prescribed non-selective NSAIDs (92%). Out of 370 at 105 prescription FDCs were prescribed. The finding conclude that although about more than 70% of patients receiving gastroprotective agents and had knowledge over NSAIDs still patients were at high to very high risk for NSAID-induced gastrointestinal complications and still there is a need of effective education/ knowledge towards NSAIDs and their pros and cons on use to the respective healthcare workers and patients in order to promote effective drug utilization. Key words : Fixed Dose Combination (FDCs), Gastro-protective Agents (GPAs), Gastrointestinal complications, Non- Steroidal Anti-inflammatory Drugs (NSAIDs),