Taylor D, Clark D W, Dovey S M, Tilyard M W
University of Otago Pharmacy School, Dunedin.
N Z Med J. 1994 Jul 13;107(981):263-6.
The aims of this study were to describe the prescribing of nonsteroidal antiinflammatory drugs (NSAIDs) by some general practitioners and to assess the information recorded on computer records on their use in individual patients so that techniques could be developed for a broader investigation of the topic in general practice.
All prescribing and consulting data from five Dunedin practices was reviewed for a 6 month period. From all consultations generating a prescription for NSAIDs, data was collected relating to the name of the drug, dosage, strength and length of treatment and patient demographic and morbidity details. Recorded adverse drug reactions were classified into six groups and four age groups were used for the analysis.
Prescriptions for NSAIDs accounted for 2.6% of all items prescribed. Diclofenac was the most commonly prescribed NSAID, for most conditions, but menstrual problems were more likely to be treated with mefenamic acid. Coprescription of possibly contraindicated medications (usually antihypertensive medicines) occurred for 20.8% of patients. Gastric adverse reactions were reported in 3% of cases while 0.9% of prescriptions resulted in no change in condition, leading to a change in therapy. Aspirin, fenbufen, ketoprofen, sulindac and flurbiprofen were never prescribed for patients under 20 years old.
Routinely recorded patient and prescribing information from general practice permits an assessment of the use of NSAIDs which includes the conditions for which they are prescribed, the total numbers prescribed, concurrent medications prescribed and their recorded adverse effects. This is not possible from any other source. Data from clinical trials provides an incomplete assessment of the use of these medications in general practice.
本研究旨在描述一些全科医生开具非甾体抗炎药（NSAIDs）的情况，并评估计算机记录中关于其在个体患者中使用的信息，以便开发相关技术，在全科医疗中对该主题进行更广泛的调查。
对达尼丁五家诊所6个月期间的所有处方和诊疗数据进行审查。从所有开具NSAIDs处方的诊疗中，收集与药物名称、剂量、强度、治疗时长以及患者人口统计学和发病情况细节相关的数据。记录的药物不良反应分为六组，并按四个年龄组进行分析。
NSAIDs处方占所有处方项目的2.6%。双氯芬酸是大多数病症最常开具的NSAID，但痛经问题更可能用甲芬那酸治疗。20.8%的患者存在可能禁忌药物（通常为抗高血压药物）的联合处方情况。3%的病例报告有胃部不良反应，而0.9%的处方未使病情改善，从而导致治疗方案改变。阿司匹林、芬布芬、酮洛芬、舒林酸和氟比洛芬从未用于20岁以下患者的处方。
全科医疗中常规记录的患者和处方信息有助于评估NSAIDs的使用情况，包括开具这些药物的病症、处方总数、联合开具的药物及其记录的不良反应。其他任何来源都无法做到这一点。临床试验数据对这些药物在全科医疗中使用情况的评估并不完整。
