Zeinali Majid, Tabeshpour Jamshid, Maziar Seyed Vahid, Taherzadeh Zhila, Zirak Mohammad Reza, Sent Danielle, Azarkhiavi Kamal Razavi, Eslami Saeid
Department of Pharmacodynamics and Toxicology, Mashhad University of Medical Sciences, Mashhad, Iran.
Social Security Organization, Mashhad, Iran.
J Res Pharm Pract. 2017 Oct-Dec;6(4):206-210. doi: 10.4103/jrpp.JRPP_17_45.
Inappropriate nonsteroidal anti-inflammatory drugs (NSAIDs) therapy is a common cause of actual and potential adverse effects, such as bleeding and gastrointestinal ulceration, which exacerbates the patient's medical condition and might even be life threatening. We aimed to evaluate and analyze the prescription pattern of NSAIDs in Northeastern Iranian population and also provide suggestions for a more rational prescription behavior for such drugs.
In this cross-sectional retrospective study, pattern of 1-year prescriptions was inspected based on 9.3 million prescriptions from two insurance companies. Type of NSAIDs, all dispensed doses and the number of NSAIDs ordered per prescription, and the route of administration for each patient were extracted from the databases. The prescription pattern of NSAIDs was analyzed seasonally.
Out of 9,303,585 prescriptions, 19.3% contained at least one NSAID. Diclofenac was the most commonly prescribed NSAID (49.21%). At least two NSAIDs were simultaneously prescribed in 7% of prescriptions. General practitioners prescribed NSAIDs more frequently (67%) than specialists. Orthopedic surgeons and internists more frequently prescribed NSAIDs in comparison with other physicians (6% and 4%, respectively). Gastroprotective agents (GPAs) were coprescribed to only 7.62% of prescriptions.
The frequency of NSAIDs prescription was relatively high in Northeast of Iran. A significant number of prescriptions were associated with irrational prescribing in both coadministration of NSAIDs and GPAs and NSAIDs combination. A strategy must be developed and implemented for prescribing and rational use of medications, e.g., continuing medical education regarding the potential risks of NSAIDs, importance of their appropriate and rational use, and necessity of appropriate prescription writing regarding both content and indication.
不恰当的非甾体抗炎药（NSAIDs）治疗是实际和潜在不良反应的常见原因，如出血和胃肠道溃疡，这会使患者病情恶化，甚至可能危及生命。我们旨在评估和分析伊朗东北部人群中NSAIDs的处方模式，并为这类药物更合理的处方行为提供建议。
在这项横断面回顾性研究中，基于两家保险公司的930万份处方检查了1年的处方模式。从数据库中提取NSAIDs的类型、所有配发剂量、每张处方中NSAIDs的订购数量以及每位患者的给药途径。对NSAIDs的处方模式进行季节性分析。
在9303585份处方中，19.3%至少包含一种NSAIDs。双氯芬酸是最常处方的NSAIDs（49.21%）。7%的处方同时开具了至少两种NSAIDs。全科医生开具NSAIDs的频率（67%）高于专科医生。与其他医生相比，骨科医生和内科医生开具NSAIDs的频率更高（分别为6%和4%）。仅7.62%的处方同时开具了胃保护剂（GPA）。
伊朗东北部NSAIDs的处方频率相对较高。在NSAIDs与GPA的联合使用以及NSAIDs组合方面，大量处方存在不合理用药情况。必须制定并实施一项药物处方和合理使用的策略，例如开展关于NSAIDs潜在风险、其合理使用的重要性以及处方内容和适应症恰当书写必要性的继续医学教育。
