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Abstract

DETERMINANT FACTORS FOR GASTRO PROTECTIVE CO PRESCRIPTION: A CROSS SECTIONAL STUDY INVOLVING 303 PATIENTS WITH NON-STEROIDAL ANTI-INFLAMMATORY DRUGS

Ravindra J, Indu TH, Raja D and Roopa B S*

ABSTRACT

Non-steroidal anti-inflammatory drugs are the core treatment for many pain and inflammatory conditions, but are associated with broad spectrum of side effects, especially Gastro Intestinal ones. This study was undertaken to determine the prescription pattern of gastro protective agents with non-steroidal anti-inflammatory drugs. This is a cross sectional observational study. Chi-square or Fisher’s exact test was used to know the distribution of categorical variables, t-test for comparison of means. Logistic regression parameters using firth procedure by quasi complete separation was used to the penalized likelihood function which makes at least one parameter estimate diverge to ± infinity. Out of 303 patients’ medical record and prescription reviewed, all the patients received non-selective anti- inflammatory drugs. Diclofenac sodium was highly prescribed anti-inflammatory drugs. 73.6% of patients had at least one gastro intestinal risk factor. Among various factors; age, acute condition and naïve usage of non-steroidal anti-inflammatory drugs were major factors for co prescription of gastro protective agents with non-steroidal anti-inflammatory drugs (P<0.005). In addition the type of hospital had significant association for the co prescription of gastro protective agents with non-steroidal anti-inflammatory drugs. In multivariate analysis the risk factors; history of ulcer, hypertension and lower respiratory tract infection were significant determinants for prescription of gastro-protective agents with non-steroidal anti-inflammatory drugs. We found profound usage of non-selective non-steroidal anti-inflammatory drugs. The commonly used GPA as prophylaxis was standard dose of H2RA which is ineffective to protect against the non-steroidal anti-inflammatory drugs related gastro intestinal ulcer complications. The study finding shows lesser extent use of Proton Pump Inhibitors.

Keywords: Non-steroidal anti-inflammatory drugs, Gastro Intestinal Risk Factors, Gastro Protective Drugs, and Prescription Pattern.


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