Beyond Pain Relief: A Cross-Sectional Study on NSAID Prescribing, Polypharmacy, and Drug Interaction Risks in Community Pharmacies

<b>Background/Objectives</b>: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used globally to manage pain and inflammation. The rising prevalence of polypharmacy and potential drug-drug interactions (pDDIs) magnified by the prolonged and irrational use of NSAIDs may jeopardize patient medication safety. This study aims to analyze the pattern in prescribing NSAIDs and assess the extent of polypharmacy and pDDIs in community pharmacies located in Ras Al Khaimah. <b>Methods</b>: A quantitative cross-sectional study was conducted in randomly selected community pharmacies over six months (July 2024 to December 2024). Prescriptions pertaining to NSAIDs were assessed for prescribing patterns; incidence of polypharmacy and pDDIs were identified using Lexicomp's drug interaction database. Chi-square tests assessed associations between treatment variables and polypharmacy, while logistic regression explored predictors of pDDIs. <b>Results</b>: In a total of 600 prescriptions, 1865 drugs were prescribed, including 908 NSAIDs. Celecoxib (28.2%) and ketoprofen (27.6%) remained the most predominant oral and topical NSAIDs prescribed. Aspirin and celecoxib were most commonly linked with pDDIs. A total of 357 pDDIs were identified, averaging 1.87 ± 1.39 per prescription. Most were of minor severity (60.22%), risk category C (43.97%), and fair reliability (59.38%). Gender, nationality, and comorbidities were significantly associated with polypharmacy (<i>p</i> < 0.001). Logistic regression showed nationality (<i>p</i> = 0.016), comorbidities (<i>p</i> < 0.001), and drug count (<i>p</i> = 0.007) as key predictors of pDDIs. <b>Conclusions</b>: Frequent NSAIDs prescribing, incidence of polypharmacy, and pDDIs underscore the attention for more cautious, evidence-based prescribing practice. Enforcing a robust regulatory framework, coupled with strengthening medication-use policies and pharmacist-led thorough medication history review and ongoing monitoring is paramount to improve patient safety and clinical outcomes.