Prescription pattern of non-steroidal anti-inflammatory drugs in patients with acute musculoskeletal pain
Keywords:NSAID, Prescription pattern, Patients
Background: Without the knowledge on how drugs are being prescribed and used, it is difficult to initiate a discussion on rational drug use and to suggest measures to change prescribing habits for the better information on the past performance of prescribers is linchpin of any auditing system. The objective of the study was to assess the NSAIDs prescription pattern in patients with MS pain.
Methods: Prospective study of prescriptions of 306 patients with MS pain presenting in orthopedic outpatient department (OPD) of Owaisi Health and Research Centre during the period of January 2014 to August 2015. Patient particulars, history and clinical findings were obtained using the study proforma. Data collected was analyzed by frequency, and percentage.
Results: Overall frequency of NSAIDs prescription in this study was 96%. Diclofenac (70.7%) was the commonest NSAID prescribed. Selective COX-2 inhibitors were not prescribed. Combination of paracetamol and tramadol (77%) was the commonest FDC prescribed among the 92 FDC prescriptions. High frequency of GPAs co-prescription (94%) was noted. Of 7 different NSAIDs prescribed, 2 drug (diclofenac, and paracetamol) falls within DU90% segment- mainly constituted by non-selective NSAIDs.
Conclusions: Overall, the prescription pattern was in accordance with standard guidelines, as suggested by the fact that the DU90%, segment was constituted by only few drugs.
International Association for the study of Pain. (Online). 2001; Available from: http://www.iasp-pain.org/content/NavigationMenu/GeneralResourceLinks/PainDefnitions/default.htm.
Fields HL, Martin JB. Pain: pathophysiology and management. In: Fauci AS, Kasper DL, Braunwald E, Hauser SL, Longo DL, Jameson JL et al. editors. Harrison’s Principles of Internal Medicine. 17th Ed. New York: McGraw-Hill; 2001.p.81-87.
Cole BE. Pain Management: Classifying Understanding, and Treating Pain. Hosp Physician. 2002;38(6):23-30.
MS problems and functional limitation. The great public health challenge for the 21st century. [Online]. 2012 July 12; Available from: http://www.boneandjointedecade.de/downloads/.eu_health-indicator-project.pdf.
Bihari V, Keshavachandran C, Pangtey BS et al. MS Pain and its associated risk factors in residents of National Capital Region. Indian J Occup Environ Med. 2011;15(2):59-63.
Brooks P. Issues with chronic MS pain. Rheumatology (Oxford). 2005;44(7):831-3.
Ullal SD, Narendranath S, Kamath RK et al. Prescribng pattern for OA in a tertiary Care hospital. J Clin Diagn Res. 2010;4(3):2421-6.
Mujahid M, Sharma M, Aqil M. Drug utilization and adverse drug reaction monitoring is NSAID users in a south Delhi Hospital. Int J Res Pharmacy Chem. 2001;2(1):103-8.
Tripathi KD. Nonsteroidal anti-inflammatory drugs and antipyretics-analgesics. In: Essentials of medical pharmacology.7thed. New Delhi: Jaypee Brothers; 2013.p.193-209.
Shankar PR, Pai R, Dubey AK et al. Prescribing pattern in the orthopaedics OPDin a teaching hospital in Pokhara, western Nepal. Kathmandu Uni Med J. 2007;5(1):16-21.
Sharma T, Dutta,S, Dhasmana DC. Prescribing Pattern of NSAIDS in orthopedic OPD of a tertiary care teaching hospital in Uttaranchal. JK Sci. 2006;8(3):160-2.
Teeling M, O ‘Connor H, Feely J, Bennett K. What therapies have replaced reofecoxib in Ireland? Br J Clin Pharmacol. 2007;64(4):536-41.
Usher C, Bennett K, Teeling M, Felly J. Characterizing new users of NSAIDs before and after rofecoxib withdrawal. Br J clin Pharmacol. 2006;64(4):494-7.
Poudel A, Palaian S, Shankar PR et al. Irrational fixed dose combinations in Nepal: Need for intervention. Kathmandu Uni Med J. 2008;6(3):399-405.
Gautam CS, Aditya S. Irrational drug combination: Need to sensitize undergraduates. Ind J Pharmacol. 2006;38(3):167-70.
Hawkey CJ, Langman MJS. Non-steroidal anti-inflammatory drugs: overall risks and management. Complementary roles for COX-2 inhibitors and proton pump inhibitors. Gut. 2003;52:600-8.
Amitava S. Indian market’s fixation with fixed dose combinations (Editorial). Ratinal Drug Bulletin. 2002:12:1.
Jadav SP, Parmar DM. Critical appraisal of irrational drug combinations: for awareness in undergraduate medical students. J Pharmacol Pharmacotherapy. 2011;2(1):45-8.
Kastury N, Singh S, Ansari KU. Fixed dose combinations and ratinal drug therapy. Indian J Pharmacol. 2001;33:458-9.
Lanas A, Garci-Tell G, Armada B et al. Prescription patterns ad appropriateness of NSAIDs therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of OA. BMC Med. 2011;9(38).
Lee SH, Han CD, Yang IH, Ha CW. Prescription Pattern of NSAIDs and the prevalence of NSAIDs-induced gastrointestinal risk factors of orthopedic patients in clinical practice in Korea. J Korean Med Sci. 2011;26;561-7.
Barozzi N, Tett SE. non steroidal anti-inflammatory drugs, cycloxygenase-2 inhibitors and Paracetamol use inQueensland and in the whole of Australia. BMC health Service research. 2008;8:196.