Utilization Pattern of NSAIDs and Gastroprotective Agents: A Prospective Analysis in Patients with Musculoskeletal Pain in A Tertiary Care Hospital

Introduction: Non steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed medications for musculoskeletal conditions. Gastroprotective agents are co-prescribed in patients using NSAIDs for long time as they are associated with gastrointestinal complications. To promote rational drug use, it is important to assess drug use pattern using the World Health Organization (WHO) drug use indicators. Aim: To determine the pattern of utilization of NSAIDs and gastroprotective agents in patients with musculoskeletal pain in Physical Medicine and Orthopedics Departments using WHO prescribing indicators. Materials and Methods: 108 case records of inpatients with musculoskeletal pain, satisfying the inclusion criteria, were analyzed prospectively for pattern of use of NSAIDs and gastroprotective agents.The data collected was analyzed for prescribing indicators, complementary indicators and other factors influencing the pattern of NSAIDs use. Descriptive statistics was used. Results: The average number of drugs prescribed per encounter was three. Percentage of drugs prescribed by generic name was 1.5% and percentage of encounters in which an injection was prescribed was 57.4%. Percentage of drugs prescribed from essential drug list (EDL) was 75.5%. Cost of drugs was affordable compared to per capita income. Diclofenac was the most commonly used NSAID. NSAIDs use was more common in women. The co-prescribed gastroprotectives were either H2 blockers (65.7%), PPIs (17.6%) or both (16.7%). Conclusion: On the basis of the finding of this study, the prescribing practices for injection and generic prescribing show deviation from the standard recommended by WHO. Overuse of injections and negligible generic prescribing need to be regulated closely. On the other hand, polypharmacy, prescribing from EDL and cost of therapy were not found to be a problem in this study. Such utilization studies will make the clinicians aware of the need for prescribing rationally.

Abstract licence: CC BY-NC-ND

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