A Prospective Study on Drug Utilization Pattern of NSAIDs in Patients Attending Orthopaedics OPD of a Tertiary Care Hospital
Background: The objective of this study was to analyse the prescribing pattern of NSAIDs in patients attending Orthopaedics OPD and to analyse the correlation between the use of selective COX-2 inhibitors and older conventional NSAIDs in the pattern of current practice. Methods: This Prospective study was conducted on Patients visiting Orthopaedics OPD of Pacific Medical College and Hospital, Udaipur, during 6 month study period. Individual data was collected in a preformed format and was analyzed on parameters such as demographic profile and NSAID's usage pattern. Results: 180 patients were selected on the basis of inclusion and exclusion criteria. Around 417 drugs were prescribed, out of which 302 were oral, 39 were topical (Table No.2). Out of 417 drugs, total number of systemic NSAID's used were 302 [72.2%]. Of these 185 (56.2%) were used as monotherapy and 144 (43.7%) were used as fixed dose combinations (FDC). Among monotherapy 103 (55.68 %) were non-selective and 82 (44.32 %) were selective COX inhibitors.
Conclusion: The result of this study suggests that the frequent use of selective COX-2 inhibitors although conventional non-selective NSAIDs topped the list of various selective and non-selective NSAIDs. Concomitant gastro protectives were also used. Fixed dose combinations were also prescribed.
2. Warner TD, Mitchell JA. Cyclooxygenase: new forms, new inhibitors and lessons from the clinic. FASEB J 2004 ; 18 ; 790-804.
3. Graumlich JF. Preventing gastrointestinal complications of NSAID's: risk factors, recent advances, and latest strategies. Postgrad Med 2001 ; 109 : 117-28.
4. Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib versus nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. The CLASS study: a randomized controlled trial. JAMA 2000 ; 284 : 1247-55.
5. Tandon VR. Pain killers and cardiovascular toxicity. Health Line Fam Med J 2006 ; 4(4) : 33-34.
6. Lamarque D. Safety of selective inhibitors of inducible cyclooxygenase -2 taken for a long period. Bull Cancer 2004 ; 91 : 117-24.
7. Mukherjee D, Nissen SE, Topol EJ. Risk of Cardiovascular evens associated with selective COX2 inhibitors. JAMA 2001 ; 286 : 954-9.
8. Mahajan A, Sharma R. Cox-2 Inhibitors : Cardiovascular Safety. JK Science 2005 ; 7(2) : 61-62.
9. Mahajan A, Verma S, Tandon V. Osteoarthritis. JAPI 2005 ; 53 : 634-41