Evaluation of Potential Drug–Drug Interactions, Polypharmacy, and Prescribing Patterns of NSAIDs Among the Older Adults in a Secondary Care Setting

Javedh Shareef,1 Sathvik Belagodu Sridhar,1 Zainab Mohammed Saeed,1 Amal Mohammed Rashed Alsereidi1,2 1Department of Clinical Pharmacy & Pharmacology, Ras Al Khaimah College of Pharmacy, Ras Al Khaimah Medical & Health Sciences University, Ras Al Khaimah, United Arab Emirates; 2Clinical Pharmacy Department, Dibba Hospital, Emirates Health Services, Al Fujairah, United Arab EmiratesCorrespondence: Javedh Shareef; Sathvik Belagodu Sridhar, Department of Clinical Pharmacy & Pharmacology, Ras Al Khaimah College of Pharmacy, Ras Al Khaimah Medical & Health Sciences University, Ras Al Khaimah, United Arab Emirates, Tel +971565915310, Email [email protected]; [email protected]: In clinical practice, non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed to older adults patients for pain and inflammation. However, drug therapy in this population carries risks of polypharmacy and potential drug–drug interactions (pDDIs). This study aimed to evaluate prescribing trends of NSAIDs and examine the incidence of polypharmacy and pDDIs among older adults patients in the Outpatient Pharmacy Department of a secondary care hospital.Patients and Methods: A prospective observational study was conducted using electronic health records of older adults patients prescribed NSAIDs from January to June 2023. Data were screened for NSAID prescription patterns, polypharmacy, and pDDIs using the Micromedex database. Descriptive statistics and logistic regression assessed relationships between treatment-related factors and pDDIs, while Chi-square tested associations between NSAID prescriptions and gastro-protective drugs. A p-value < 0.05 was considered statistically significant.Results: The study was conducted in 174 older adults patients. Celecoxib (28.2%) and ketoprofen (27.6%) were the most often given oral and topical NSAIDs among the study populations, respectively. Aspirin and celecoxib were the most commonly involved NSAIDs causing pDDIs. A total of 340 potential pDDIs were found, with a mean of 1.95 ± 3.66 interactions for each prescription. The analysis of polypharmacy in relation to treatment factors revealed a significant correlation with comorbidities (p < 0.001). A robust positive association exists between the quantity of pDDIs and continuous treatment-related factors, including the Charlson comorbidity index (p = 0.004), the comorbidity burden (p < 0.001), and the overall number of medications being taken (p < 0.001).Conclusion: The research elucidates the prescribing trends of NSAIDs and uncovers the occurrence of polypharmacy and pDDIs within the older adults population. Giving the right screening and intervention resources to maximize their medication regimen may ensure safer and more effective management of older adults patients.Plain Language Summary: Doctors often give older people NSAIDs (non-steroidal anti-inflammatory meds) to help with pain and swelling. But as people get older, they are more likely to be given more than one medicine at a time, which is called polypharmacy. Taking many drugs raises the chance of bad side effects, especially when several drugs interact in harmful ways. These are known as possible drug-drug interactions (pDDIs).This study looked at how NSAIDs are given to older people who go to a secondary care hospital’s outpatient pharmacy. Researchers got information from people 60 and older who were given NSAIDs between January and June 2023. The study examined which NSAIDs were most commonly used, how many patients were taking more than one medication, and how often pDDIs happened. We used a medical database called Micromedex to identify the interactions.There were 174 senior patients in the study. Celecoxib (oral) and ketoprofen (topical gel) were the NSAIDs doctors prescribed most. Aspirin and celecoxib were the NSAIDs that most often interacted with other drugs. There were 340 pDDIs in all, averaging over two per prescription. The results showed that patients who used more medications and had greater health problems were more likely to have pDDIs.The study shows that older persons need to be watched closely and that doctors should be more careful when giving drugs. Better screening and advice for doctors and pharmacists could help lower risks and make patients safer.Keywords: older adults, prescription pattern, poly pharmacy, drug-drug interactions, non-steroidal anti-inflammatory drugs