OBJECTIVE: To assess whether prescribing non-steroidal anti-inflammatory drugs (NSAIDs) is adequate for gastrointestinal protection associated with NSAID use. DESIGN: Cross-sectional descriptive study. SETTING: Primary Care Centre in La Mina, Barcelona, Spain. PARTICIPANTS: A random sample of 500 patients, stratified by doctor was selected from a total of 4504 patients with an NSAID prescription. MAIN MEASUREMENTS: The dependent variables were the adequacy of NSAID prescription and gastrointestinal protection. The independent variables were: age, sex, concomitant treatments, type and number of NSAIDs. The variables were collected from the clinical history. RESULTS: The 476 patients included with an NSAID prescription had a mean age of 47.9 (18.1) years, and 63.4% were women. The NSAIDs most prescribed were, ibuprofen (60.3%), diclofenac (23.1%), and naproxen (4.0%). The most common reason for prescribing the NSAID was locomotor system pathology; 45.4%. The prescription was adequate in 44.7% (95% CI, 40.2-49.3), and inadequate in 23.5% (95% CI, 19.8-27.6). It was inadequate in 49.5% of patients over 65 years, while in under 65 year-olds 16.5% were inadequate. Gastrointestinal protection was inadequate in 28.2% (95% CI, 22.7-35.7); 12.8% excessive and 16% insufficient. In the multivariate analysis, the inadequacy probability of NSAIDs is 5.45 times greater in patients of 65 or more years than in younger patients. CONCLUSIONS: NSAID prescribing and gastrointestinal protection can be considered to be inadequate in 25% of patients. Advanced age is a major risk factor in inadequate prescribing.
OBJECTIVE: To assess whether prescribing non-steroidal anti-inflammatory drugs (NSAIDs) is adequate for gastrointestinal protection associated with NSAID use. DESIGN: Cross-sectional descriptive study. SETTING: Primary Care Centre in La Mina, Barcelona, Spain. PARTICIPANTS: A random sample of 500 patients, stratified by doctor was selected from a total of 4504 patients with an NSAID prescription. MAIN MEASUREMENTS: The dependent variables were the adequacy of NSAID prescription and gastrointestinal protection. The independent variables were: age, sex, concomitant treatments, type and number of NSAIDs. The variables were collected from the clinical history. RESULTS: The 476 patients included with an NSAID prescription had a mean age of 47.9 (18.1) years, and 63.4% were women. The NSAIDs most prescribed were, ibuprofen (60.3%), diclofenac (23.1%), and naproxen (4.0%). The most common reason for prescribing the NSAID was locomotor system pathology; 45.4%. The prescription was adequate in 44.7% (95% CI, 40.2-49.3), and inadequate in 23.5% (95% CI, 19.8-27.6). It was inadequate in 49.5% of patients over 65 years, while in under 65 year-olds 16.5% were inadequate. Gastrointestinal protection was inadequate in 28.2% (95% CI, 22.7-35.7); 12.8% excessive and 16% insufficient. In the multivariate analysis, the inadequacy probability of NSAIDs is 5.45 times greater in patients of 65 or more years than in younger patients. CONCLUSIONS: NSAID prescribing and gastrointestinal protection can be considered to be inadequate in 25% of patients. Advanced age is a major risk factor in inadequate prescribing.
Authors: José Luis Marco Garbayo; Manuel Koninckx Cañada; Isabel Pérez Castelló; María Teresa Faus Soler; Rosa Fuster Torres; Mar Moncho Escrivà Journal: Eur J Hosp Pharm Date: 2016-11-07