scholarly journals Prescription pattern of non-steroidal anti-inflammatory drugs (NSAIDs) among community patients with musculoskeletal and co-morbid conditions: A crosssectional study from an Iraqi province

2021 ◽  
Vol 20 (1) ◽  
pp. 203-210
Author(s):  
Anmar Al-Taie ◽  
Ali N. Hussein ◽  
Zahraa Albasry
Keyword(s):  
Musculoskeletal Disorders ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cross Sectional ◽  
Gastrointestinal Complications ◽  
Co Morbidity ◽  
Significant Difference ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Cv Disease

Purpose: To determine the pattern of prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) co-prescription with NSAIDs in a sample of patients suffering from musculoskeletal disorders with and without co-morbid cardiovascular (CV) disease conditions in Baghdad Province, Iraq.Methods: A descriptive, cross-sectional study was conducted using a structured questionnaire to assess the clinical characteristics of patients that used NSAIDs alone or with PPIs for the treatment of different musculoskeletal disorders with and without co-morbid cardiovascular (CV) disease conditions.Results: A total of 102 participants were enrolled in the study. More than half of the participants had comorbid disease conditions (53.9 %), particularly hypertension (47.1 %). Nearly a quarter of the participants with CV disease conditions used non-selective NSAIDs (25.5 %). The majority of NSAIDs intake were orally administered for more than one month (79.4 %). Physicians were the major source for patient education about the risk of NSAIDs-associated complications according to 59.6 % of the participants. The majority of participants reported non-adherence to the prescribed PPIs (86.5 %). There was a statistically significant difference between the participants that used NSAIDs alone, and those with PPI co-prescription within the age group of 31 - 60 years (p < 0.0001) and for a duration of more than one month for NSAIDs administration (p < 0.0001).Conclusion: There is improper use of NSAIDs, particularly the non-selective agents, among patients with co-morbid cardiovascular disease conditions, as well as poor medication adherence and improper co-prescription of PPIs. This requires periodic revision for long-term intake of NSAIDs, while applying more care to high-risk patients regarding co-prescription of NSAIDs with PPIs. Keywords: Cardiovascular, Co-morbidity, Gastrointestinal complications, NSAIDs, Proton-pump inhibitors

Gastroprotection during long-term NSAID use – what we know after 120 years of observations?

2021 ◽  
Vol 14 (2) ◽  
pp. 132-137
Author(s):  
Michał Lipiński
Keyword(s):  
Side Effects ◽  
Risk Stratification ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Broad Spectrum ◽  
Nsaid Therapy ◽  
Gastrointestinal Complications ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed classes of medications. The broad spectrum of side effects following long-term NSAID therapy includes mainly, but not only, gastrointestinal complications. Risk stratification of the gastrointestinal complications events is an important element of planning NSAIDs therapy, which allows to determine the indications for the use of proton pump inhibitors. This article presents the criteria for assessment and the method of adequate prevention of gastrointestinal side effects in patients receiving long-term NSAID therapy.

Abstract P372: U.S. National Estimates of Prescription Nonsteroidal Anti-inflammatory Drugs Among Patients With Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Andrew Y Hwang ◽  
Steven M Smith
Keyword(s):  
Heart Disease ◽  
Boxed Warning ◽  
Self Report ◽  
Cross Sectional ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Anti Inflammatory ◽  
Cv Disease ◽  
Prescription Nsaid

Introduction: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain, fever, and inflammation, but their ubiquitous use has led to concerns over increased risk of adverse cardiovascular (CV) events, particularly in patients with established CV disease (CVD). In 2005, the FDA revised labels for all NSAIDs to include a boxed warning highlighting the potential for increased CV risk. However, little is known regarding real-world prescribing of NSAIDs among patients with CVD. Our objective was to characterize the use of prescription NSAIDs among patients with CVD from 1988-2016 in the U.S. Methods: Using cross-sectional National Health and Nutrition Examination Survey (NHANES) data from 1988-1994 and 1999-2016, we included participants aged ≥18 years with hypertension (defined by self-report, mean blood pressure ≥140/90, or use of an antihypertensive medication), or aged ≥20 years with ≥1 of the following self-reported heart disease conditions: congestive heart failure (CHF), coronary heart disease (CHD), angina, myocardial infarction (MI), or stroke. Survey-weighted data were analyzed to assess prevalence and trends of prescription NSAID use within each CVD population in 6-year examination periods. Results: Overall, prescription NSAID use declined among all U.S. CVD populations over the study period. Prevalence of prescription NSAID use was highest during the 1999-2004 examination years, but thereafter, declined during the 2005-2010 examination years for those with hypertension (13.9% to 8.8%), CHF (14.6% to 8.5%), CHD (16.3% to 7.0%), angina (17.6% to 9.73%), MI (16.1% to 8.2%), and stroke (15.7% to 8.8%). Use of prescription NSAIDs since the 2005-2010 examination years has remained consistent in all CVD populations. These decreases were driven in part by reduced use of COX-2-selective NSAIDs, whereas non-selective NSAID use among all CVD populations was relatively steady from 1999 to 2016. Conclusions: Prescription NSAID use among patients with CVD appears to have declined from 1988 to 2016, primarily because of less COX-2 NSAID use following removal of 2 approved agents. Otherwise, the prevalence of prescription NSAIDs has remained somewhat stable and relatively high among these high-risk CV populations. Our results suggest additional efforts may be needed to limit the use of NSAIDs among patients with CVD, given that these agents are known to be associated with adverse CVD outcomes.

Adherence to proton pump inhibitors or H 2 -receptor antagonists during the use of non-steroidal anti-inflammatory drugs

2003 ◽  
Vol 18 (11-12) ◽  
pp. 1137-1147 ◽  
Author(s):  
M. C. J. M. Sturkenboom ◽  
T. A. Burke ◽  
M. J. D. Tangelder ◽  
J. P. Dieleman ◽  
S. Walton ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Receptor Antagonists ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Features of manifestations, treatment and prevention of nsaids – induced gastroduodenopathy in patients of different profile departments

2019 ◽  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Clinical Manifestations ◽  
Duodenal Ulcers ◽  
Group Iii ◽  
Treatment And Prevention ◽  
Group I ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Gastroduodenal Zone

Introduction. Nonsteroidal anti-inflammatory drugs are the most commonly used medicines in medical practice. As literary sources show, they often cause unwanted side-effects. The purpose of our work was to evaluate the frequency, clinical manifestations and morphological features of lesions of the gastroduodenal zone that arise in patients of rheumatologic, neurological profiles and angiosurgery department during the course of treatment with nonsteroidal anti-inflammatory drugs of different groups, to trace the dependence of the frequency of manifestations of the pathology of the stomach and duodenum from simultaneous receiving two nonsteroidal anti-inflammatory drugs and their combination with glucocorticosteroids and anticoagulants. Material and methods. 73 patients who had used NSAIDs for a long time and had endoscopically confirmed medicated gastroduodenopathy. Patients were divided into 3 groups depending on the profile of the department: Group I included - 24 patients of the department of vascular surgery; Group II - 23 patients of the neurological department; Group III - 26 patients with rheumatological profile. Results. Asymptomatic clinical picture of NSAID-gastropathy was found, which did not coincide with the available endoscopic changes in the gastroduodenal tube: in 63% of cases, erosive changes in the mucous membrane were present, and stomach and duodenal ulcers were revealed in 11%. It was also found that in the group of patients receiving proton pump inhibitors, the incidence of gastroduodenopathy was reliably lower (34.2%) than in patients who did not receive them (53.4%). During this study, it was found that the use of selective non-steroidal anti-inflammatory drugs can significantly reduce the probability of developing the pathology of the gastroduodenal zone, compared with non-selective. Conclusions. The course of treatment with nonsteroidal anti-inflammatory drugs should be as short as possible and should be carried out with minimal but effective doses. Parallel prophylactic administration of proton pump inhibitors is appropriate in patients at high risk of developing erosions and ulcers in the background of treatment with these drugs.

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