J Korean Med Sci.  2011 Apr;26(4):561-567. 10.3346/jkms.2011.26.4.561.

Prescription Pattern of NSAIDs and the Prevalence of NSAID-induced Gastrointestinal Risk Factors of Orthopaedic Patients in Clinical Practice in Korea

Affiliations
  • 1Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hacw@skku.edu
  • 2Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Abstract

This is a cross-sectional observational study undertaken to explore the current prescription pattern of non-steroidal anti-inflammatory drugs (NSAIDs) and the prevalence of NSAID-induced gastrointestinal (GI) risk factors of orthopaedic patients in real clinical practice in Korea. Study cohort included 3,140 orthopaedic outpatients at 131 hospitals and clinics between January 2008 and August 2008. A self-administered questionnaire was completed by each patient and physician. A simplified risk scoring scale (the Standardized Calculator of Risk for Events; SCORE) was used to measure patients' risk for GI complications. The pattern of NSAIDs prescription was identified from medical recordings. Forty-five percents of the patients belonged to high risk or very high risk groups for GI complications. The cyclooxygenase-2 enzyme (COX-2) selective NSAID showed a propensity to be prescribed more commonly for high/very high GI risk groups, but the rate was still as low as 51%. In conclusion, physician's considerate prescription of NSAIDs with well-understanding of each patient's GI risk factors is strongly encouraged in order to maximize cost effectiveness and to prevent serious GI complications in Korea. Other strategic efforts such as medical association-led education programs and application of Korean electronic SCORE system to hospital order communication system (OCS) should also be accompanied in a way to promote physician's attention.

Keyword

Anti-Inflammatory Agents, Non-Steroidal; GI risk factor; Cyclooxygenase 2 Inhibitors; SCORE; Korea

MeSH Terms

Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
Cohort Studies
Cross-Sectional Studies
Cyclooxygenase 2/metabolism
Cyclooxygenase 2 Inhibitors/adverse effects
Drug Prescriptions
Female
Gastrointestinal Diseases/chemically induced/complications/*epidemiology
Humans
Male
Middle Aged
Musculoskeletal Diseases/complications/*drug therapy
Prevalence
Questionnaires
Republic of Korea
Risk Factors

Figure

  • Fig. 1 Composition of GI risk groups according to SCORE tool.


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