Usage and Prescribing Patterns of NSAID in Different General and Specialized Hospitals in Bangladesh

Abstract

Introduction: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed and used for the treatment of pain and inflammation. Though this type of drug contains many side effects, these are widely used. The present study was conducted to observe the prescribing pattern. The study aimed to observe and assess the usage pattern and prescribing pattern of NSAIDs based on collected data from multiple general and specialized hospitals. Methods: This cross-sectional descriptive study was conducted at multiple hospitals in Mymensingh district during the 2- year period from January 2015 to December 2016. For the purpose of this study, a total of 1216 patients of all ages and gender were selected based on whether they were prescribed NSAIDs. Result: Among the participants, 71.4% of the participants using NSAIDs were between the ages of 15-45 years. The difference in prevalence between different age groups was highly significant. Higher male prevalence was observed, with 60.4% male and 39.6% female population. The difference between male and female prevalence was statistically significant. The chief complaint/clinical diagnosis were mentioned as fever (20.1%); backache (15.6%); headache (12.0%); musculoskeletal pain (11.5%); traumatic injury (7.1%); dysmenorrhea (5.3%); infective condition (4.6%); post-surgical pain (1.5%) and others (5.6%) of total prescription. One drug was prescribed in 2.5%, two drugs were in 32.7%, three drugs were in 41.6%, four drugs were in 17.6%, five drugs were in 5.3% and six drugs were prescribed 0.3% prescriptions respectively. Out of the total of 1216 prescriptions: 15.6% were prescribed by a specialist doctor, 63.8% by an MBBS doctor, and 20.6% were prescribed by unqualified prescribers. Cost of prescribed NSAIDs was <10 BDT for 50.5%, 10-50 BDT for 42.9%, >50 BDT for 5.8% and for the remaining 0.8%, the price of prescribed NSAID was unknown. The commonest prescribed NSAIDs were paracetamol (42.1) diclofenac sodium (21.9%); ibuprofen (10.4%); naproxen (5.9%); aspirin (1.6%) and other NSAIDs (18.1%) were prescribed respectively. The commonest prescribed dosage from NSAIDs was tablet/capsule (83.7%); syrup (9.0%); suppository (3.0%); injection (2.0%); suspension (1.8%); topical application (0.5%) was prescribed respectively. Statistically, there was a relationship between different dosage forms of the drug. Tablet/capsule was the highest significant form of the drug. Conclusion: The patients usually consulted with an MBBS doctor. The chief complaint/clinical diagnosis are a fever for patients who consulted the prescribers. The commonest prescribed NSAID is paracetamol. NSAIDs are mentioned in the trade name in most cases. The commonest prescribed dosage of NSAIDs is tablet/capsule