Nonsteroidal Anti-inflammatory Drugs Utilization Patterns and Risk of Adverse Events due to Drug-Drug Interactions among Elderly Patients: A Study from Jordan
Date
2020Item Type
ArticleAbstract
Background: Worldwide, the prescribing pattern of the Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
has increased. They are considered highly effective medications in controlling various conditions including
inflammatory diseases. They are associated with various adverse effects including gastrointestinal bleed ing and ulcer and renal toxicity though. These adverse effects are generally potentiated when NSAIDs are
co-prescribed with other drugs that share similar adverse effects and toxicities. Developing severe side
effects from NSAIDs is more prone among elderly patients. Hence, it is crucial to evaluate prescribing pat tern of these agents to prevent/decrease the number of unwanted side effects caused by NSAIDs.
Aim: The aim of this study is to assess the prescribing pattern of NSAIDs among elderly and the co prescribing of NSAIDs and different interacting drugs, which could lead to more incidences of NSAIDs induced toxicities among Jordanian elderly patients.
Settings and Methodology: A multicenter retrospective study was performed during a three months period
in Jordan. The study involves a total number of (n = 5916) elderly patient’s records obtained from Four gov ernmental hospitals in Jordan.
Results: A total number of (n = 20450) drugs were prescribed and dispensed for patient. NSAIDs drugs pre scribing percentage was 10.3% of total medications number. Aspirin was the most commonly prescribed
NSAIDs among patients (70.4%), followed by Diclofenac sodium in all dosage forms (25.1%) and oral
Ibuprofen (3.1%. In addition, Aspirin was the highest NSAIDs co-prescribed with ACEI (e.g., Enalapril),
ARBs (e.g. Candesartan and Losartan), Diuretics (Furosemide, Indapamide, Hydrochlorothiazide,
Amiloride, and Spironolactone), Warfarin and antiplatelets (Clopidogreal and Ticagrelor) followed by
Diclofenac and other NSAIDs.
Conclusion: NSAIDs prescribing rate among elderly patients was high. Additionally the co-prescribing of
NSAIDs especially Aspirin with other agents, which contributes to NSAIDs nephrotoxicity and gastrointesti nal toxicity, were high. Strict measurements and action plans should be taken by prescribers to optimize the
medical treatment in elderly through maximizing the benefits and decreasing the unwanted side effects.
Author
Al-Azayzih, Ahmad
Al-Azzam, Sayer I.
Alzoubi, Karem H.
Jarab, Anan S.
Kharaba, Zelal
Al-Rifai, Rami H.
Alnajjar, Munther S.