dverse Drug Reactions and Drug Interactions of Non-Steroidal Anti İnflammatory Drugs in Elderly Patients Attending Teaching Hospital Karapitiya

Abstract

Background: Elders are highly susceptible for Non-Steroidal Anti-İnflammatory Drugs (NSAIDs) related Adverse Drug Reactions (ADR) and drug interactions if they are treated with number of medications for multiple comorbidities. Objective: To evaluate the NSAIDs related adverse drug reactions, and drug interactions among the elderly patients attending outdoor pharmacy of Teaching Hospital Karapitiya (THK) Methods: A descriptive cross-sectional study was conducted at the outdoor pharmacy of THK. Sample consisted of 317 elderly patients over 60 years age who were attending routine clinics and taking NSAIDs from the outdoor pharmacy. Data were collected using an interviewer administered questionnaire consisted of 21 questions. SPSS version 25.0 and Microsoft Excel 2013 were used in the data analysis. Chi-squared test was used to identify the association between categorical variables. Results: NSAIDs related ADRs were experienced by 44.5% of the participants. Dyspepsia was the most frequently occurred NSAIDs related ADR (81.6%). Reporting dyspepsia is significantly associated with the type of NSAIDs prescribed (p=0.001). Among the patients reporting dyspepsia, majority (77.4%) were prescribed with non-selective NSAIDs. The patients co prescribed with PPI had less percentage (47.1%) for dyspepsia (p<0.001). Majority of the participants, (67.8%) were prescribed with at least one potentially interacting drug with NSAIDs. Drugs for hypertension, heart failure and other cardiac problems (42.90%), and antithrombotics (34.38%) were the commonly co-prescribed potentially interacting drugs with NSAIDs. There were 4.7% of elders prescribed with triple whammy combination. Polypharmacy was observed in 83% who were on NSAIDs. There was a significant association between polypharmacy and the prevalence of potentially interacting drugs (p=0.001). Conclusions: Dyspepsia is the most common NSAID related ADR reported in elderly patients. Co-prescription of drugs that have potential interactions with NSAIDs is common among elders. Multiple morbidities and polypharmacy are common characteristics among patients who were prescribed potentially interacting drugs