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 bleeding 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 pattern 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 governmental hospitals in Jordan.

Results

A total number of (n = 20450) drugs were prescribed and dispensed for patient. NSAIDs drugs prescribing 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 gastrointestinal 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.

中文翻译：

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老年患者中非甾体抗炎药的使用模式和药物相互作用引起的不良事件风险：来自约旦的一项研究

背景

在全球范围内，非甾体抗炎药 (NSAID) 的处方模式有所增加。它们被认为是控制各种疾病（包括炎症性疾病）的高效药物。它们与各种不良反应有关，包括胃肠道出血、溃疡和肾毒性。当非甾体抗炎药与其他具有相似副作用和毒性的药物合用时，这些副作用通常会增强。老年患者更容易出现 NSAID 的严重副作用。因此，评估这些药物的处方模式以预防/减少非甾体抗炎药引起的不良副作用的数量至关重要。

目标

本研究的目的是评估老年人非甾体抗炎药的处方模式以及非甾体抗炎药和不同相互作用药物的共同处方，这可能导致约旦老年患者中非甾体抗炎药诱导的毒性发生率更高。

设置和方法

在约旦进行了为期三个月的多中心回顾性研究。该研究涉及从约旦四家政府医院获得的总数 (n = 5916) 老年患者的记录。

结果

为患者开具和分配的药物总数为 (n = 20450)。非甾体抗炎药处方比例为总用药数的10.3%。阿司匹林是患者中最常用的非甾体抗炎药 (70.4%)，其次是所有剂型中的双氯芬酸钠 (25.1%) 和口服布洛芬 (3.1%)。此外，阿司匹林是与 ACEI（例如依那普利）合用的最高非甾体抗炎药)、ARBs（如坎地沙坦和氯沙坦）、利尿剂（速尿、吲达帕胺、氢氯噻嗪、阿米洛利和螺内酯）、华法林和抗血小板药物（氯吡格雷和替格瑞洛），其次是双氯芬酸和其他非甾体抗炎药。

结论

老年患者的非甾体抗炎药处方率较高。此外，非甾体抗炎药，尤其是阿司匹林与其他药物的共同处方，导致非甾体抗炎药肾毒性和胃肠道毒性的发生率很高。处方者应采取严格的措施和行动计划，通过最大化利益和减少不必要的副作用来优化老年人的医疗。