Objectives: The objectives of this study were 1) to obtain
information regarding the prescribing pattern of nonsteroidal
anti-inflammatory drugs (NSAIDs) in the primary care setting at a
Malaysian university, 2) to determine the prevalence and types of
potential NSAID prescriptionrelated problems (PRPs), and 3) to identify
patient characteristics associated with exposure to these potential
PRPs.
Methods: We retrospectively collected data from 1 academic
year using the electronic medical records of patients in the University
Sains Malaysia (USM) primary care system. The defined daily dose (DDD)
methodology and the anatomical therapeutic chemical (ATC) drug
classification system were used in the analysis and comparison of the
data. Statements representing potential NSAID PRPs were developed from
authoritative drug information sources. Then, algorithms were developed
to screen the databases for these potential PRPs. Descriptive and
comparative statistics were used to characterize DRPs. Results:
During the study period, 12,470 NSAID prescriptions were prescribed for
6,509 patients (mean ± SD = 1.92 ± 1.83). This represented a prevalence
of 35,944 per 100,000 patients, or 36%. Based on their DDDs, mefenamic
acid and diclofenac were the most prescribed NSAIDs. 573 potential
NSAID-related PRPs were observed in a cohort of 432 patients,
representing a prevalence of 6,640 per 100,000 NSAIDs users, or 6.6% of
all NSAID users. Multivariate logistic regression analysis revealed that
patients with a Malay ethnic background (p < 0.001), members of the
staff (p < 0.001), having 4 or more prescribers (p < 0.001) or
having 2 – 3 prescribers (p = 0.02), and representing 4 or more
long-term therapeutic groups (LTTGs) (p < 0.001) or 2 – 3 LTTGs (p
< 0.001) were significantly associated with an increased chance of
exposure to potential NSAIDrelated PRPs.
Conclusions: This is the
first study in Malaysia that presents data on the prescribing pattern
of NSAIDs and the characteristics of potential NSAID-related PRPs. The
prevalence of potential NSAID-related PRPs is frequent in the primary
care setting. Exposure to these PRPs is associated with specific
sociodemographic and health status factors. These results should help to
raise the awareness of clinicians and patients about serious NSAID
PRPs