Resumen de Valuation of the adequacy and safety of nsaid in patients of a district of primary care
Ana Sela Ordóñez Soto, José Asterio Ortega Blanco, Miguel Pedregal González, Concepción Pérez Guerrero
Objectives: Main objective: To evaluate adequacy of anti-inflammatory treatments in patients of a Sanitary District. Specific: to characterize the inadequacies of anti-inflammatory treatments according to indications of the Summary of Product Characteristics, cardiovascular and gastrointestinal risk.
Method: Design: A descriptive transversal study. Location: Primary Care. Participants: patients for whom some NSAID were dispensed in the period between September and November, 2013. Random sampling. The study estimates 23% of prevalence, 7% of precision and 95% of reliability, adding 5% (No. = 137).
Measurements: age, sex, NSAID, pathology, duration of treatment, gastroprotective drug, cardiovascular risk, factors of gastrointestinal risk, kidney factors, indication, dosage, contraindications and relevant interactions.
Results: Women 66.4%, mean age 63.09 years (SD 10.41). 22.6% were prescribed diclofenac, 21.2% ibuprofen, 15.3% dexketoprofen, 11.7% celecoxib,10.9% etoricoxib. 75% had scheduled a NSAID for a period of 3-12 months (47.06% of these were over 65 years old). 43.4% had osteoarthritis. 77.37% had some gastrointestinal risk factor (11.32% of these without gastroprotective drug).
Vascular risk: Low 58.39%, moderated 13.13%, high 28.47%.
Kidney failure 4.38%. 21.9% had scheduled the triple therapy (ACEI/ARA-II, diuretic and NSAID), of which 3 patients had kidney failure.
6.57% did not have an authorized indication (all in treatment with coxib).
8.03% did not have an adequate dose. 11.68% had one contraindication.
Conclusions: NSAID are used for long periods for chronic diseases, mainly in elderly patients with gastrointestinal risk factors, some without gastroprotective drug. It is necessary to improve the adequacy of anti-inflammatory drugs to cardiovascular risk, especially with diclofenac and coxibs
