Authors : Ashok Kumar, Vasant R.Chavan, Mohammaed Arshad, Raghunanadan M, Mohammed Fayazuddin
DOI : 10.18231/j.ijpp.2019.009
Volume : 6
Issue : 2
Year : 2019
Page No : 37-41
Introduction: Osteoarthritis (OA) is a major cause of chronic pain and lower extremity disability among the elderly due to its predilection for lower extremity joints such as the knee and hip. The treatment of pain and inflammation is an important area of therapeutics. Over the past two decades, non steroidal anti-inflammatory drugs (NSAIDs) have played a central role in these indications. NSAIDs constitute the largest single group of drugs used worldwide, constituting more than 20% of all drug prescriptions. In India over 400 formulations of NSAIDs are marketed, resulting in wide spread exposure of patients to this class of drugs and its adverse effects, For all these reasons, studies that evaluate the pattern, extent and frequency of NSAID prescriptions are valuable. Periodic evaluation of drug utilization studies provides the information for suitable modifications in the prescription of drugs in order to increase the therapeutic benefit and decrease the adverse effect associated with drug.
Materials and Methods: A prospective, observational study was conducted on newly diagnosed as well as old treated patients with osteoarthritis from orthopaedic outpatient department in a tertiary care teaching hospital. A total of 428 were enrolled after screened for the inclusion and exclusion criteria. Data was recorded in a specially designed proforma which include information regarding the demographic profile of the patients and about the pattern of drugs prescribed.
Results: Four hundred and twenty-eight patients with the diagnosis of Osteoarthritis visited the orthopedic outpatient department during the period of six months in which the data was collected. Prescriptions of all 428 patients were analyzed. Osteoarthritis was found to be more common in males (56.07%) compared to that of females (43.92%). Results also revealed that, OA was more prevalent in middle age group of 51-65 years (45.32%),with knee joint (66.58%) being most commonly effected, majority of patient were treated with Combination therapy (80.80%) over Monotherapy (19.19%).
Most of patients were treated as first line with NSAIDS (79.75%) and Paracetamol (20.10%), was under prescribed. Aceclofenac (32.85%) was the most common NSAID used followed by Diclofenac sodium (25.49%).
Gastroprotective agents were used in 12.28% along with Non-selective NSAIDS to prevent gastrointestinal adverse effects, out of which Ranitidine (53.47%) was most preferred, followed by Pantoprazole (16.66%), Various other drugs were also used as adjunct therapies that includes, Calcium and Vitamin D3, symptomatic slow acting drugs for OA (SYSADOA) which included diacerin and glucosamine sulfate as combination in (10.15%) of patients.
Conclusions: Our study showed Osteoarthritis most common among males affecting knee joint in middle age group, Paracetamol and SYSADOA being under prescribed and NSAIDS are the most frequently used drugs in OA. National drug policy is needed to rationalize the drug use and bring awareness among the prescribing doctors.
Keywords: Osteoarthritis, NSAIDS, Paracetamol, Diclofenac sodium, Prescription pattern analysis, Tertiary care hospital.