Prescription pattern and appropriateness of non- steroidal anti- inflammatory drug therapy in patients with osteoarthritis- a cross sectional study.

Objectives: Current medical management of osteoarthritis (OA) is mostly palliative with non-steroidal anti-inflammatory drugs (NSAIDs) being the mainstay of therapy. NSAIDs are commonly used despite well-known side effect which may lead to various adverse drug reactions and drug toxicity. Therefore, the objectives of the study are to analyse the prescription pattern of NSAIDs in OA patients and to assess appropriateness of the use of NSAIDs in relation to gastrointestinal and cardiovascular risk. Methods: A cross sectional study was carried out among patients attending orthopaedics out- patient department & provisionally diagnosed as OA. Patients who were prescribed any of the following drugs or their combinations were included in the study: NSAIDs, Glucocorticoids, Opioid analgesics and Symptomatic Slow Acting Drugs for OA (SYSADOA). To assess prescription pattern, ‘WHO core prescribing indicators’ were used Analysis of appropriateness of NSAIDs use by the prescribers in relation to GI & CV risks, the recommendations of the ‘First International Working Party Report on Management of Patients on NSAIDs’ were adopted and categorised as appropriate or inappropriate or uncertain. Data were entered in statistical software ‘EpiInfo’. Data were represented by suitable tables & figures and expressed in frequency and percentage. Results: A total 600 OA patients were included in the study. Out of 600 prescriptions, NSAIDs were prescribed in 547 prescriptions (91.17%). Total 402 prescriptions were analyzed for appropriateness of NSAIDs therapy. Out of total 402 prescriptions, 222 (55.23%) prescriptions were found appropriate, 127 (31.59%) inappropriate and 53 (13.18%) were found as uncertain. Conclusions: The study showed that NSAIDs should be selected more judiciously for OA patients in relation to GI and CV risk in order to reduce untoward adverse effects of these agents. Key-words: NSAIDs, Prescription pattern, Appropriateness.