title: Evaluating ethnic differences in the prescription of NSAIDs for chronic kidney disease: a cross-sectional survey of patients in general practice.
abstract: BACKGROUND
  The public health burden of chronic kidney disease (CKD) and end-stage kidney disease is a national priority and is the subject of recent guidelines. In the UK, ethnic minority groups are over-represented in the renal replacement population (17.8%) compared with the white population (11%).
  
  
  OBJECTIVE
  Non-steroidal anti-inflammatory drugs (NSAIDs) are a preventable cause of renal damage. Previous studies suggest a prescribing prevalence between 9% and 36% among those with CKD, but have not examined differences by ethnic group.
  
  
  METHODS
  Cross-sectional survey of 12 011 patients with identified CKD (stages 3-5) in the three PCTs of Tower Hamlets, Hackney, and Newham.
  
  
  METHODS
  Assessment of NSAID prescribing rates in a multi-ethnic, socially-deprived population, using descriptive and multivariate analysis.
  
  
  RESULTS
  NSAIDs were prescribed for 11.1% of patients with CKD in the year prior to November 2012. Prescribing rates decreased stepwise by stage of renal impairment. Using daily defined dosages this study shows that in comparison with white groups both South Asian and black groups are much less likely to be in the top decile of NSAID prescribing, hence the overall prescribing load will be less: (odds ratio [OR] for South Asians = 0.34, 95% confidence interval [CI] = 0.22 to 0.54, OR for black groups = 0.34, 95% CI = 0.19 to 0.63).
  
  
  CONCLUSIONS
  National rates of NSAID prescribing continue to rise, and over-the-counter sales remain unmonitored, despite longstanding concerns about renal outcomes. Prescribing patterns indicate that GPs reduce prescribing as CKD progresses. Differential use of NSAIDs by ethnic group is unlikely to contribute to the high rates of end-stage kidney disease in ethnic minority groups.
authors: Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK.
authors: Sally
authors: S
authors: Hull
authors: Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK.
authors: Rohini
authors: R
authors: Mathur
authors: Renal Department, Barts Health NHS Trust, London, UK.
authors: Gavin
authors: G
authors: Dreyer
authors: Renal Department, Barts Health NHS Trust, London, UK.
authors: Muhammad Magdi
authors: MM
authors: Yaqoob
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001211:Asia, Western / Q000208:ethnology; D044383:Black People / Q000208:ethnology; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000208:ethnology; D044465:White People / Q000208:ethnology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: NSAID prescribing; chronic kidney disease; ethnicity; general practice