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http://dx.doi.org/10.15268/ksim.2020.8.4.079

A Study on the Prescription Patterns of Gastrointestinal Protective Agent with Non-Steroidal Anti-Inflammatory Drugs in Korean Elderly Patients with Osteoarthritis  

Chun, Seongmin (Dept. of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital)
Choi, Yoonhee (Dept. of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital)
Publication Information
Journal of The Korean Society of Integrative Medicine / v.8, no.4, 2020 , pp. 79-92 More about this Journal
Abstract
Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.
Keywords
aged; GPAs; NSAIDs; osteoarthritis; prescribing patterns;
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