Abstract

PREVALENCE OF ADMINISTRATION OF NON STEROIDAL ANTIINFLAMMATORY DRUGS AND GASTROPROTECTIVE AGENTS IN ORTHOPAEDIC OUTPATIENT DEPARTMENT AT KATHMANDU MEDICAL COLLEGE TEACHING HOSPITAL

Jagadishwor Maharjan, Rajan Manandhar*, Bishnu Prasad Kandel, Sanukaji Shrestha and Jaya Bahadur Ghale

ABSTRACT

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are most commonly used drugs for the management of pain and inflammation with proven efficacy. Despite wide clinical use of NSAIDs as analgesics, antipyretics, and anti-inflammatory agents, their gastrointestinal toxicities such as dyspepsia, peptic ulcers and gastrointestinal bleeding are a major clinical limitation. Thus for the prevention of gastrointestinal adverse effects in NSAIDs users, gastro protective agent (GPA) such as proton pump inhibitor (PPI), H2 blocker, antacid is co-prescribed along with NSAIDs. Objective: The main objective of the study was to investigate whether NSAIDs is given as monotherapy or in combination with gastro protective agents in orthopedic OPD of Kathmandu Medical College Teaching Hospital (KMCTH), Sinamangal, Kathmandu, Nepal. Methodology: All thepatients prescribed with NSAIDs in orthopedic OPD of KMCTH during the study period of 6 months were included for the study. The data was collected from the outpatient card of the patients who were attending orthopedic OPD and recorded in customized proforma. The collected data were entered In Microsoft excel 2007 and descriptive statistics was used to analyse the data with the help of statistical package for social sciences (SPSS) 17 version software, p value less than 0.05 was considered statistically significant. Ethical clearance for the present study was obtained from the Institutional Review Committee of KMCTH. Results: On the basis of inclusion and exclusion criteria 403 prescriptions were screened. Aceclofenac (75.9%) was the commonest drug prescribed for most of the indications in orthopaedic OPD. High prevalence of GPA co-prescription with NSAIDs was observed (91.32%). Among various GPAs pantoprazole (50.6%) was most commonly prescribed. Trauma was most common indication for attending orthopedic OPD at KMCTH. High rate of compliance were observed for both NSAIDs and GPAs i.e. 95.40% and 93.43% respectively. Conclusion: Although the prescribing pattern of NSAIDs and concomitant use of PPIs was analyzed in the present study, but their exists limitation of the study was that it was carried out on only 403 patients. A multicentre, longer duration, involving more number of patients need to be carried out further in order to come to a final conclusion.

Keywords: NSAID’s, Aceclofenac, Pantoprazole, Patient compliance.