Evaluation of Potential Drug-Drug Interactions, Polypharmacy, and Prescribing Patterns of NSAIDs Among the Older Adults in a Secondary Care Setting.

PURPOSE: In clinical practice, non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed to older adults patients for pain and inflammation. However, drug therapy in this population carries risks of polypharmacy and potential drug-drug interactions (pDDIs). This study aimed to evaluate prescribing trends of NSAIDs and examine the incidence of polypharmacy and pDDIs among older adults patients in the Outpatient Pharmacy Department of a secondary care hospital.

PATIENTS AND

METHODS

A prospective observational study was conducted using electronic health records of older adults patients prescribed NSAIDs from January to June 2023. Data were screened for NSAID prescription patterns, polypharmacy, and pDDIs using the Micromedex database. Descriptive statistics and logistic regression assessed relationships between treatment-related factors and pDDIs, while Chi-square tested associations between NSAID prescriptions and gastro-protective drugs. A p-value <0.05 was considered statistically significant.

RESULTS

The study was conducted in 174 older adults patients. Celecoxib (28.2%) and ketoprofen (27.6%) were the most often given oral and topical NSAIDs among the study populations, respectively. Aspirin and celecoxib were the most commonly involved NSAIDs causing pDDIs. A total of 340 potential pDDIs were found, with a mean of 1.95 ± 3.66 interactions for each prescription. The analysis of polypharmacy in relation to treatment factors revealed a significant correlation with comorbidities (p < 0.001). A robust positive association exists between the quantity of pDDIs and continuous treatment-related factors, including the Charlson comorbidity index (p = 0.004), the comorbidity burden (p < 0.001), and the overall number of medications being taken (p < 0.001).

CONCLUSION

The research elucidates the prescribing trends of NSAIDs and uncovers the occurrence of polypharmacy and pDDIs within the older adults population. Giving the right screening and intervention resources to maximize their medication regimen may ensure safer and more effective management of older adults patients.