OBJECTIVES:The objectives of this study were 1) to obtain information regarding the prescribing pattern of nonsteroidal anti-inflammatory drugs (NSAIDs) in the primary care setting at a Malaysian university, 2) to determine the prevalence and types of potential NSAID prescription related problems (PRPs), and 3) to identify patient characteristics associated with exposure to these potential PRPs.
METHODS:We retrospectively collected data from 1 academic year using the electronic medical records of patients in the University Sains Malaysia (USM) primary care system. The defined daily dose (DDD) methodology and the anatomical therapeutic chemical (ATC) drug classification system were used in the analysis and comparison of the data. Statements representing potential NSAID PRPs were developed from authoritative drug information sources. Then, algorithms were developed to screen the databases for these potential PRPs. Descriptive and comparative statistics were used to characterize DRPs.
RESULTS:During the study period, 12,470 NSAID prescriptions were prescribed for 6,509 patients (mean ± SD = 1.92 ± 1.83). This represented a prevalence of 35,944 per 100,000 patients, or 36%. Based on their DDDs, mefenamic acid and diclofenac were the most prescribed NSAIDs. 573 potential NSAID-related PRPs were observed in a cohort of 432 patients, representing a prevalence of 6,640 per 100,000 NSAIDs users, or 6.6% of all NSAID users. Multivariate logistic regression analysis revealed that patients with a Malay ethnic background (p < 0.001), members of the staff (p < 0.001), having 4 or more prescribers (p < 0.001) or having 2 - 3 prescribers (p = 0.02), and representing 4 or more long-term therapeutic groups (LTTGs) (p < 0.001) or 2 - 3 LTTGs (p < 0.001) were significantly associated with an increased chance of exposure to potential NSAID related PRPs.
CONCLUSIONS:This is the first study in Malaysia that presents data on the prescribing pattern of NSAIDs and the characteristics of potential NSAID-related PRPs. The prevalence of potential NSAID-related PRPs is frequent in the primary care setting. Exposure to these PRPs is associated with specific sociodemographic and health status factors. These results should help to raise the awareness of clinicians and patients about serious NSAID PRPs.
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【Associations between prescribing nonsteroidal anti-inflammatory drugs and the potential prescription-related problems in a primary care setting.].
【非甾体类抗炎药的处方与基层医疗机构中潜在的处方相关问题之间的关联。】
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DOI：10.5414/CP201689文章类型：杂志文章
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目的：本研究的目的是：1）获得有关马来西亚大学初级保健机构中非甾体抗炎药（NSAIDs）处方模式的信息； 2）确定与NSAID处方相关的潜在问题的患病率和类型（PRPs），以及3）识别与暴露于这些潜在PRPs相关的患者特征。
方法：我们使用马来西亚赛恩斯大学（USM）初级保健系统中患者的电子病历，回顾性收集了1个学年的数据。定义的日剂量（DDD）方法和解剖治疗化学（ATC）药物分类系统用于数据的分析和比较。代表潜在的NSAID PRP的陈述是从权威的药物信息来源中得出的。然后，开发了用于筛选数据库以查找这些潜在PRP的算法。描述性统计数据和比较统计数据用于表征DRP。
结果：在研究期间，为6,509名患者开出了12,470份NSAID处方（平均±SD = 1.92±1.83）。这表示每100,000名患者中有35,944名患病率，占36％。根据其DDDs，甲芬那酸和双氯芬酸是处方最多的非甾体抗炎药。在432名患者中观察到573种潜在的与NSAID相关的PRP，占每100,000个NSAID使用者中6,640的患病率，占所有NSAID使用者的6.6％。多元logistic回归分析显示，具有马来族裔背景（p <0.001），职员（p <0.001），有4名或更多处方者（p <0.001）或有2-3名处方者（p = 0.02）的患者，代表4个或更多长期治疗组（LTTG）（p <0.001）或2-3个LTTG（p <0.001）与暴露于潜在的与NSAID相关的PRPs的机会增加显着相关。
结论：这是马来西亚的第一项研究，其提供了关于非甾体抗炎药处方模式和潜在的非甾体抗炎药相关PRPs特征的数据。在初级保健机构中，潜在的与NSAID相关的PRP的患病率很高。接触这些PRP与特定的社会人口统计学和健康状况因素相关。这些结果应有助于提高临床医生和患者对严重NSAID PRP的认识。
方法：我们使用马来西亚赛恩斯大学（USM）初级保健系统中患者的电子病历，回顾性收集了1个学年的数据。定义的日剂量（DDD）方法和解剖治疗化学（ATC）药物分类系统用于数据的分析和比较。代表潜在的NSAID PRP的陈述是从权威的药物信息来源中得出的。然后，开发了用于筛选数据库以查找这些潜在PRP的算法。描述性统计数据和比较统计数据用于表征DRP。
结果：在研究期间，为6,509名患者开出了12,470份NSAID处方（平均±SD = 1.92±1.83）。这表示每100,000名患者中有35,944名患病率，占36％。根据其DDDs，甲芬那酸和双氯芬酸是处方最多的非甾体抗炎药。在432名患者中观察到573种潜在的与NSAID相关的PRP，占每100,000个NSAID使用者中6,640的患病率，占所有NSAID使用者的6.6％。多元logistic回归分析显示，具有马来族裔背景（p <0.001），职员（p <0.001），有4名或更多处方者（p <0.001）或有2-3名处方者（p = 0.02）的患者，代表4个或更多长期治疗组（LTTG）（p <0.001）或2-3个LTTG（p <0.001）与暴露于潜在的与NSAID相关的PRPs的机会增加显着相关。
结论：这是马来西亚的第一项研究，其提供了关于非甾体抗炎药处方模式和潜在的非甾体抗炎药相关PRPs特征的数据。在初级保健机构中，潜在的与NSAID相关的PRP的患病率很高。接触这些PRP与特定的社会人口统计学和健康状况因素相关。这些结果应有助于提高临床医生和患者对严重NSAID PRP的认识。
