Evaluation of prescription pattern of analgesic use among ambulatory elderly in South-Western Nigeria

Abstract

Background: Inappropriate prescribing of analgesics has a global impact on the health of elderly patients and the society. Empirical evidence on the prescription of analgesics among elderly Nigerians is scarce. Objectives: The objective of the study was to evaluate the prescription pattern of analgesics and describe the co-prescribing of gastroprotective agents with non-steroidal anti-inflammatory drugs (NSAIDs) among elderly patients at the geriatric center, University College Hospital, Ibadan. Methods: A retrospective cross-sectional, hospital-based study was carried out among elderly patients (≥60 years) who were prescribed analgesics. Using a data extraction sheet, information on demographic characteristics, drug utilization pattern, and morbidities was obtained from patients’ case files via electronic health records. Results: A total of 337 patients case files were reviewed, the mean age was 72 ± 8.8 years, and 210 (62.3%) were females. There were a total of 2074 medications prescribed, with 733 (35.3%) being analgesics. Majority of the elderly patients (259, 76.9%) were on nonopioids, with 252 (74.8%) on NSAIDs. Paracetamol was the most commonly prescribed analgesics (181, 24.6%), followed by diclofenac/misoprostol (177, 24.1%), opioid analgesic prescribed was 88 (12.0%), with paracetamol/codeine 58 (65.9%), and tramadol 16 (18.2%) being the most prescribed opioid. A significant proportion of the hypertensive elderly patients (160, 78.8%; P < 0.036) were on NSAIDs. The oral route of administration (302, 89.6%) was the most common route of administration. Majority (310, 92%) of elderly patients taking NSAIDs had a co-prescription for gastroprotective agents. Conclusions: Majority of hypertensive patients were on NSAIDs. This calls for prompt awareness of rational analgesic use among the elderly to improve management and their survival.

Prescription Analysis of Outpatients in a Tertiary Care Hospital in Khyber Pakhtunkhwa, Pakistan

“…and Ragaven, L.B., 2020 (15%). 32 Our result somewhat contrasted with the findings of Irshaid et al, Balbaid and Al-Dawood, and Makonnen et al 30,33,34 The study has revealed a high propensity to omit required information (like. starting date of a drug, signature of prescribing doctor, dose, dosage form, strength, route, drug spellings etc.)…”

“…In our study, 35.88% of the prescription were illegible prescription, which was due to the poor handwriting that may lead to dispensing the wrong medications. These results of studies are contrasted with those reported by Al Slamah, Thamer., et al (64.3%), 30 Tobaiqy, M. and Stewart, D, (7.2%) 31 and Nkera-Gutabara, J.G. and Ragaven, L.B., 2020 (15%).…”

Economic Cost of the Waste of Anti-inflammatory and Analgesic Drugs in Mexico City

“…Acetaminophen, ASA, and diclofenac were the most frequently prescribed anti-inflammatory agents in the general population in such regions, as well as in the geriatric and pediatric patients. [22][23][24] It has been posed that the high prevalence of discarded anti-inflammatory drugs might derive from a steady increase in the geriatric population and the tendency of the elderly to use a greater amount of NSAIDs compared to other age groups in the population. 14) Whatever the cause may be of the high prevalence of the prescription and purchase of AAMs, the focus of the current contribution is the tendency of these drugs to accumulate in homes.…”

Framework of Guidelines for Management of CKD in Asia

“… 164 , 165 Physicians should note a detailed history of previous and current medications, including herbal medicines. 166 Individuals should be counseled to avoid alternative medicines, especially those with a known risk of renal damage or with known drug interactions.…”