Non-steroidal anti-inflammatory drug prescriptions in hospital inpatients: are we assessing the risks?
OBJECTIVE
To determine non-steroidal anti-inflammatory drug (NSAID) prescribing practices in a tertiary referral hospital.


METHODS
A single time-point audit of drug kardexes and clinical notes of n = 388 patients on 2 July 2008 was carried out assessing demographics, gastrointestinal and coronary heart disease risk factors, renal function and co-prescribed medications.


RESULTS
Fifty-seven of 388 (14.7%) hospital patients were on NSAIDs. Forty-nine were prescribed NSAID after admission. Nineteen (32.2%) were on regular NSAID (11/19 on PPI) and 38 patients were on PRN NSAID (12/38 on PPI). Seventeen of 49 patients were on other medications associated with gastrointestinal bleeding (10/17 were on PPI). Nineteen patients (33.3%) were >60 years. Eight patients had three or four risk factors for gastrointestinal bleeding; six were on PPI. Thirteen patients had two risks; 7 were on PPI. Six of 19 patients with one risk factor were on PPI. 40.3% had stage 2/3 chronic kidney disease. 35.1% had ischaemic heart disease.


CONCLUSIONS
NSAIDs and PPIs are often prescribed inappropriately.
Department of Rheumatology, Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. kitchen.jo@gmail.com
J
J
Kitchen
D
D
Kane
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007494:Ireland; D008485:Medical Audit; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors