Shakil Baig, Mujhaid Humail, Ittat H Zaidi, Sadiq Rehman.
Prescribing trends of nonsteroidal anti-inflammatory drugs (NSAIDS) in Karachi.
J Pak Orthop Assoc Jan ;20(2):141-6.

Objective: To study as to how the local doctors in Karachi prescribe non-steroidal antiinflammatory drugs, relative to analgesics for various musculoskeletal painful conditions. Study Design: Descriptive prospective case series. Patients and Methods: Case-notes and previous prescriptions brought by consecutive patients presenting at Baqai Rheumatology Unit in outpatients were screened for prescribers’ speciality, qualifications and practicing status. Details of all medications including category, dosage and duration were obtained. Conditions for which NSAIDS or analgesics prescribed were recorded from patients’ history. Demographic details were obtained. Simple frequencies and percentages were calculated for different variables. Results: 101 prescriptions from 85 patients were analysed. NSAIDS were prescribed to 89 patients whereas analgesics alone were given to only 12 patients. This is despite of the fact hat almost two-third of the patients were suffering from either a mechanical or a degenerative onditions. Co-prescription of two or more NSAIDS given at the same time was observed in almost one-third of consultant grade and General practitioners (GPs) and to a lesser extent (22%) in the Senior Teaching Post Holders (STPH). Conventional NSAIDS were more frequently used than COXIBS. The use of Gastro-protective Agents (GPA) was observed in 29 prescritions but without strict adherence high risk individuals. H2RA in conventional dosages were preferred over PPI. Conclusion: A much higher than expected trend to use NSAIDS possibly exists. Coprescription of multiple NSAIDS is dangerously high and exists even in the senior teaching post holders rendering these patients even more vulnerable to toxicity. The use of Gastroprotective agents also does not frequently comply with international guidelines.

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