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High-risk nonsteroidal anti-inflammatory drugs prescribing in primary care: results from National Medical Care Survey Malaysia

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dc.contributor.authorWen Yea Hwong
dc.contributor.authorYvonne Mei Fong Lim
dc.contributor.authorEe Ming Khoo
dc.contributor.authorSheamini Sivasampu
dc.date.accessioned2024-07-30T02:47:14Z
dc.date.available2024-07-30T02:47:14Z
dc.date.issued2020
dc.description.abstractBackground: Information on the extent of high-risk prescribing for nonsteroidal anti-infammatory drugs (NSAIDs) across developing countries is scarce. Objectives This study examines the prescribing pattern for NSAIDs in primary care, assesses the extent of high-risk NSAIDs prescribing and identifes associated factors. Setting 129 public and 416 private primary care clinics in Malaysia. Methods Data were derived from the National Medical Care Survey 2014, a cross-sectional survey on primary care morbidity patterns and clinical activities in Malaysia. Types of NSAIDs, indications for NSAIDs use and propor tion of high-risk NSAIDs prescribing were assessed. Factors associated with high-risk NSAIDs prescribing were identifed with a multivariable logistic regression. Weighted results, adjusted for sampling design and non-response were presented. Main outcome measures: Prescribing pattern of NSAIDs, proportion of high-risk NSAIDs prescribing and its associated factors. Results Among the 55,489 patients who received NSAIDs, diclofenac was the most frequently prescribed NSAID (40.5%, 95% CI 40.1–40.9%), followed by mefenamic acid (29.2%, 95% CI 28.8–29.6%). The commonest indications for NSAIDs use were musculoskeletal condition and respiratory tract infection, both at 17.8% (95% CI 17.4–18.1%). A total of 22.9% (95% CI 22.6–23.3%) patients received high-risk NSAID prescriptions. Of these, 47.8% (95% CI 46.9–48.7%) did not receive adequate gastroprotection despite being at risk, 24.8% (95% CI 24.0–25.5%) were prescribed NSAIDs despite having cardiovascular comorbidities and 22.4% (95% CI 21.7–23.2%) were prescribed high-dose NSAIDs. The odds of receiving high-risk NSAID prescriptions increased with the number of drugs prescribed (OR 1.23, 95% CI 1.06–1.43) and the number of diagnoses in one visit (OR 2.21,95% CI 1.71–2.86). The odds of being prescribed high-risk NSAID prescriptions were lower in patients with secondary (OR 0.52, 95% CI 0.35–0.77) and tertiary education (OR 0.39, 95% CI 0.22–0.68) compared to patients without formal education. Patients’ citizenship, indication for NSAID prescriptions and whether a medical certifcate was issued were also signifcantly associated with the likelihood of receiving high-risk NSAID prescriptions. Conclusions: A quarter of NSAIDs prescribed in Malaysian primary care setting is categorised as high-risk prescribing. Targeted strategies are necessary to improve patient safety.
dc.identifier.doi10.1007/s11096-020-00966-w
dc.identifier.urihttps://link.springer.com/article/10.1007/s11096-020-00966-w
dc.identifier.urihttps://repository.nih.gov.my/handle/123456789/732
dc.language.isoen
dc.publisherSpringerNature
dc.relation.ispartofInternational Journal of Clinical Pharmacy
dc.relation.issn2210-7711
dc.relation.journalInternational Journal of Clinical Pharmacy
dc.subjectDrug utilization review
dc.subjectHigh-risk prescribing
dc.subjectMalaysia
dc.subjectNon-steroidal anti-infammatory agents
dc.subjectNSAIDs
dc.subjectPrimary health care
dc.titleHigh-risk nonsteroidal anti-inflammatory drugs prescribing in primary care: results from National Medical Care Survey Malaysia
dc.typejournal-article
dspace.entity.typePublication
oaire.citation.issue2
oaire.citation.volume42
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