A Study of Prescribing Patterns for Non-Steroidal Anti-Inflammatory Drugs in a Tertiary Care Teaching Hospital

Abstract

Analgesics, including nonsteroidal anti-inflammatory drugs, are a commonly prescribed group of drugs in clinical practice for the management of pain and inflammation. This study was carried out to evaluate the prescribing pattern for nonsteroidal anti-inflammatory drugs in the tertiary care teaching hospital. A prospective cross sectional study was conducted in the orthopaedic department of a tertiary care teaching hospital from February to December 2017. The institutional ethical committee approved the study. Patients of both genders were included in the study. Patients treated with at least one nonsteroidal anti-inflammatory drug in the outpatient department of orthopaedics were included. The prescription was compared with World Health Organization drug prescribing indicators to compare selective and nonselective nonsteroidal anti-inflammatory drugs associated with the treatment also concurrent prescription of gastro protective agents. The data collected was analysed by descriptive statistics. Chi-Square test was used to compare the difference between the two groups. A p value of <0.05 was considered significant. Out of 500 prescriptions included in the study, the total number of drugs prescribed was 1098, of which were nonsteroidal anti-inflammatory drugs. Based on the World Health Organization’s drug use indicators, the average number of drugs per encounter was 2.19 % and the average number of nonsteroidal antiinflammatory drugs per encounter was 1.38 %. Out of all the nonsteroidal anti-inflammatory drugs prescribed, 428 (62.20 %) were from National List of Essential Medicine India 2015 and 678 (98.5 %) nonsteroidal anti-inflammatory drugs were prescribed by generic name. Among the study population, only 40 % of patients were prescribed Proton Pump Inhibitors along with nonsteroidal anti-inflammatory drugs. Proton Pump Inhibitors are effective in ulcer prophylaxis in their standard dose. The present study concluded that among cyclooxygenase-1 inhibitors, Diclofenac was the most commonly prescribed nonsteroidal anti-inflammatory drugs from the national list of essential medicine. The most frequently prescribed cyclooxygenase-2 inhibitor in this study was Etoricoxib. The percentage of analgesic prescribed by generic name was excellent. However, the average number of drugs per prescription deviated from the World Health Organization’s rational drug use indicator. The use of gastro protective agents needs to be rationalised with nonsteroidal anti-inflammatory drugsy