Prevalence of prescribing pattern of more than one NSAID in Pakistan

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) represent diverse group of drug with analgesic property and most frequently prescribed drug globally.This is first choice of drug with well demonstrated efficiency for the pain management primarily musculoskeletal disorder and osteoarthritis to treat mild to moderate pain.Although its serious toxicity related to GIT limits its expediency.”Big evil” have tendency to just cure pain relieving symptoms not disease.In this study we aimed to determine the prescribing practice of multiple NSAIDs in Pakistan by healthcare practitioner and their attitude towards patient life safety and what consequences are responsible for irrational practice of these most common OTC drug. For the purpose of this evaluation discriptive studies was conducted based on prescription reading and case histories of more than 200 patients to rule out prescribing habit of physicians. Prescription collected were mostly from emergency (80%) and general physicians (20%). Nearly everyone patient came with intense pain related with muscular and arthritis pain. About 69% patients were being prescribed by double NSAIDs in which acetaminophen ratio was mostly high with Diclofenac sodium (ratio of 60:35). Single practice of NSAIDs has reported just 25% but more than prescription containing multiple NSAIDs 6%. Traditional NSAIDs prescribed more frequently compared to selective NSAIDs by physician which makes patients susceptible to GIT associated toxicity. For the prophylaxis of NSAIDs associated GIT bleeding only 15% patients were coprescribe by H2 receptor blocker primarily ranitidine (15%) and PPis (7%) and other (2%). After careful consideration about prescribing habit of NSAIDs by physician we conclude that the irrational practices prevalence have been rising dangerously which needs careful consideration by health authorities.