Use of non-steroidal anti-inflammatory drugs in outpatients in Serbia: Observational study

Introduction and objectives: Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with anti-inflammatory, analgetic and antipyretic properties and are used in the treatment of acute mild to moderate pain, chronic pain and inflammatory conditions and fever. The aim of the study was to analyze the consumption of NSAIDs, purpose of use, length of therapy, adverse effects and patient's perception about efficacy and safety of the drugs. All patients, who had a NSAID prescribed, were included in the study. Method: The research was done in the Military Medical Academy, Belgrade, Serbia from June to December 2008. A questionnaire filled with the assistance of a pharmacist, contained questions about co morbidities, use and adverse effects of NSAIDs. All patients with at least one NSAID prespription (diclofenac, ibuprofen, flurbiprofen, naproxen, piroxicam, tenoxicam, meloxicam) were included in the study. The responses were statistically processed using the /-test. Results: 160 patients were included in the study. The majority of the patients (59.4%) used one NSAID in tablet form (48.8%). The most frequent used were diclofenac and ibuprofen. 51.9% suffered from rheumatic diseases for more than 5 years. Every other patient used both NSAIDs and gastroprotective drugs, most often ranitidine (58.1%). Conclusion: The results show that rheumatic diseases are often present in older patients and that treatment with NSAIDs lasts longer than five years. Mild gastric problems have been recorded as adverse effects of NSAIDs, most often nausea and pain in the stomach. This is probably due to the frequent use of diclofenac and ibuprofen, drugs with low or moderate risk for gastric toxicity as well as the concomitant use of H2-antagonists and proton pump inhibitors.