Use of non-steroidal anti-inflammatory drugs in outpatients in Serbia: Observational study

Abstract

Introduction and objectives: Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with anti-inflammatory, analgetic and antipyretic properties and are used in the treatment of acute mild to moderate pain, chronic pain and inflammatory conditions and fever. The aim of the study was to analyze the consumption of NSAIDs, purpose of use, length of therapy, adverse effects and patient's perception about efficacy and safety of the drugs. All patients, who had a NSAID prescribed, were included in the study. Method: The research was done in the Military Medical Academy, Belgrade, Serbia from June to December 2008. A questionnaire filled with the assistance of a pharmacist, contained questions about co morbidities, use and adverse effects of NSAIDs. All patients with at least one NSAID prespription (diclofenac, ibuprofen, flurbiprofen, naproxen, piroxicam, tenoxicam, meloxicam) were included in the study. The responses were statistically processed using the /-test. Results: 160 patients were included in the study. The majority of the patients (59.4%) used one NSAID in tablet form (48.8%). The most frequent used were diclofenac and ibuprofen. 51.9% suffered from rheumatic diseases for more than 5 years. Every other patient used both NSAIDs and gastroprotective drugs, most often ranitidine (58.1%). Conclusion: The results show that rheumatic diseases are often present in older patients and that treatment with NSAIDs lasts longer than five years. Mild gastric problems have been recorded as adverse effects of NSAIDs, most often nausea and pain in the stomach. This is probably due to the frequent use of diclofenac and ibuprofen, drugs with low or moderate risk for gastric toxicity as well as the concomitant use of H2-antagonists and proton pump inhibitors.

Uvod i cilj rada: Nesteroidni antiinflamatorni lekovi (NSAIL) ispoljavaju antiinflamatorno, analgetičko i antipiretičko dejstvo i primenjuju se kod akutnih bolova blagog do umerenog intenziteta, hroničnih bolnih i zapaljenskih stanja, te povišene telesne temperature. Cilj ove studije bio je da se analizira vanbolnička potrošnja NSAIL, način primene, dužina terapije i neželjene reakcije, kao i iskustva pacijenata u vezi sa efikasnošću i bezbednošću lekova. U studiju su uključeni svi pacijenti kojima je propisan NSAIL. Metode: Istraživanje je sprovedeno u Vojnomedicinskoj akademiji u Beogradu, u periodu od juna do decembra 2008. godine. Pacijenti su, uz pomoć farmaceuta, popunjavali upitnik koji se sastojao od pitanja vezanih za pridružena oboljenja, upotrebu i neželjene efekte NSAIL. U studiju su uključeni svi pacijenti kojima je na recept bio propisan neki od NSAIL (diklofenak, ibuprofen, flurbiprofen, naproksen, piroksikam, tenoksikam, meloksikam). Odgovori su statistički obrađeni primenom x2-testa. Rezultati: U studiji je učestvovalo 160 pacijenata. Većina pacijenata (59,4%) je koristila jedan NSAIL, 48,8% ispitanika je primenjivalo lek u obliku tablete. Diklofenak i ibuprofen su najčešće korišćeni lekovi. U ispitivanoj grupi pacijenata, 51,9% pacijenata je bolovalo od reumatične bolesti duže od 5 godina. Svaki drugi pacijent je istovremeno primenjivao NSAIL i gastroprotektivni lek, najčešće ranitidin (58,1%). Zaključak: Rezultati pokazuju da se NSAIL često primenjuju duže od pet godina, u lečenju reumatičnih bolesti koje su zastupljene kod starijih pacijenata. Najčešći neželjeni efekti NSAIL su blagi gastrointestinalni problemi, nauzeja i bol u stomaku. Ovo se objašnjava time što se najviše koriste diklofenak i ibuprofen, lekovi koji imaju slab ili umeren rizik za ispoljavanje gastričnih neželjenih efekata, ali i zbog istovremene primene NSAIL i H2-blokatora/inhibitora protonske pumpe.