A study on the prevalence of risk factors associated with non-steroidal anti-inflammatory drugs-induced adverse effects among inpatients at a tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20252578Keywords:
NSAIDs, Risk factors, Drug-drug interactions, PrevalenceAbstract
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for pain relief and as antipyretics in day-to-day life. However, their adverse effects can be intensified in the presence of certain risk factors. This study aims to identify the risk factors associated with NSAID-induced adverse effects. It also serves to support clinical pharmacists in minimizing these risks and enhancing patient safety.
Methods: Data from a total of 175 inpatients were collected prospectively using a structured data collection form based on defined inclusion and exclusion criteria. The study was conducted over a period of six months. The WHO-UMC causality assessment scale was used to evaluate adverse drug reactions (ADRs), and Hartwig’s severity assessment scale was used to determine the severity. SPSS software was employed for analysing the categorized data.
Results: Among 175 patients receiving NSAID therapy, the most prevalent risk factor identified was polypharmacy (64%), followed by older age (38%). Preventive co-therapies, such as proton pump inhibitors (PPIs), were administered in 81.1% of cases. The study also reported a specific ADR generalized pruritus induced by diclofenac, which was assessed as probable on the WHO-UMC causality scale and mild (Level 2) on Hartwig’s severity scale.
Conclusions: The study concludes that all NSAID prescriptions were rational and appropriate. Identifying risk factors and prescribing preventive co-therapies during NSAID treatment contributes to improved patient care and therapeutic outcomes.
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References
Shidhani A, Rawahi N, Rawahi A. Non-steroidal anti-inflammatory drugs (NSAIDs) use in primary health care centers: A Clinical Audit. Oman Med J. 2015;30(5):366-74. DOI: https://doi.org/10.5001/omj.2015.73
Tripathi KD. Essentials of medical pharmacology 9th ed. New Delhi: Jaypee Brothers medical publishers (p) Ltd. 2019;209-26.
Tomic M, Micov A, Pecikoza U, Stepanovic-Petrovic R. Clinical uses of nonsteroidal anti-inflammatory drugs (NSAIDs) and potential benefits of NSAIDs modified-release preparations. In Microsized and nanosized carriers for nonsteroidal anti-inflammatory drugs. 2017;1(1):1-29. DOI: https://doi.org/10.1016/B978-0-12-804017-1.00001-7
Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP. Risk factors for NSAID associated upper GI clinical events in a long-term prospective study of 34,701 arthritis patients. Aliment Pharmacol Therapeut. 2010;32(10):1240-8. DOI: https://doi.org/10.1111/j.1365-2036.2010.04465.x
Peck TE, Hill SA. Pharmacology for anaesthesia and intensive care, 4th edition. Cambridge University Press. 2014;1-355. DOI: https://doi.org/10.1017/CBO9781107477605
Jame DS. The multisystem adverse effects of NSAID therapy. J Osteopath Med. 1999;99(11):1-7. DOI: https://doi.org/10.7556/jaoa.1999.99.11.S1
Harirforoosh S, Asghar W, Jamali F. Adverse effects of Non-steroidal anti-inflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. J Pharmacy Pharmaceut Sci. 2013;16(5):821-47. DOI: https://doi.org/10.18433/J3VW2F
Lee SH, Han CD, Yang IH, Ha CW. Prescription pattern of NSAIDs and the prevalence of NSAID-induced gastrointestinal risk factors of orthopaedic patients in clinical practice in Korea. J Korean Med Sci. 2011;26(4):561-78.
Bardou M, Barkun AN. Preventing the gastrointestinal adverse effects of nonsteroidal anti-inflammatory drugs: from risk factor identification to risk factor intervention. Joint Bone Spine. 2010;77(1):6-12. DOI: https://doi.org/10.1016/j.jbspin.2009.11.008
Bjorkman DJ. Current status of Non-steroidal anti-inflammatory drug (NSAID) use in the United States: risk factors and frequency of complications. Am J Med. 1999;107(6):3-8. DOI: https://doi.org/10.1016/S0002-9343(99)00362-9
Weinblatt ME. Drug liberations With Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Scandinavian J Rheumatol. 1989;18(1):7-10. DOI: https://doi.org/10.3109/03009748909101471
Parthasarathi G. A textbook of clinical pharmacy practice 2nd ed. University Press (India) private limited. 2020;104-22.
Pirmohamed M, Breckenridge AM, Kitteringham NR, Park BK. Adverse drug reactions. BMJ. 1998;316(7140):1295-8. DOI: https://doi.org/10.1136/bmj.316.7140.1295
Inamdar Z, Sarwamangala SN, Padmavati V, Dalal VI, Bali PN. Prescription Pattern Analysis of Non-Steroidal Anti-Inflammatory Drugs In a tertiary care hospital. Asian J Pharmaceut Sci Clin Res. 2022;15(7):177-80. DOI: https://doi.org/10.22159/ajpcr.2022.v15i7.44669
Kumar S, Thakur PK, Sowmya K, Priyanka S. Evaluation of prescribing pattern of NSAIDs in south Indian teaching hospital. J Chitwan Med College. 2016;6(4):54-8. DOI: https://doi.org/10.3126/jcmc.v6i4.16716
Gul S, Ayub M. Prevalence of prescribing pattern of more than one NSAID in Pakistan. J SciInnov Res. 2014;3(2):148-54. DOI: https://doi.org/10.31254/jsir.2014.3206
Vaishnavi PR, Gaikwad N, Dhaneria SP. Assessment of nonsteroidal anti-inflammatory drug use pattern using world health organization indicators: A cross-sectional study in a tertiary care teaching hospital of Chhattisgarh. Indian J Pharmacol. 2017;49(6):445-53. DOI: https://doi.org/10.4103/ijp.IJP_189_17
Bahreini A, Koneri R. Prescription Pattern Analysis of Nonsteroidal Anti‑ Inflammatory Drugs in the Southeastern Karnataka Population, India. Arch Pharma Pract. 2020;11(S1):116-9.
Rafaniello C, Ferrajolo C, Sullo MG, Sessa M, Sportiello L. Risk of gastrointestinal complications associated to NSAIDs, low-dose aspirin and their combinations: Results of a pharmacovigilance reporting system. Pharmacolog Res. 2016;104(1):108-14. DOI: https://doi.org/10.1016/j.phrs.2015.12.026
Ravi Teja P, Sandari B, Priya L, Kishore R. A Clinical Study on prescribing pattern of NSAIDs and Assessment of drug interactions. ACTA Scientific Pharmaceut Sci. 2020;4(5):84-7.
Lipworth L, Abdel-Kader K, Morse J, Stewart TG, Kabagambe EK, Parr SK, et al. High prevalence of Non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study. BMC Nephrol. 2016;17(1):1-9. DOI: https://doi.org/10.1186/s12882-016-0411-7
Lee SH, Han CD, Yang IH, Ha C. Prescription pattern of NSAID-induced gastrointestinal risk factors of orthopaedic patients in clinical practice in Korea. J Kor Med Sci. 2011;26(4):561-7. DOI: https://doi.org/10.3346/jkms.2011.26.4.561
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