Perceptions and Beliefs Regarding NSAIDs in the Asia-Pacific Region

Self-reporting of adverse drug reactions of nonsteroidal anti-inflammatory drugs in community pharmacies

Background

Ibuprofen and diclofenac are nonsteroidal anti-inflammatory drugs widely used worldwide. Spontaneous reporting often results in an underestimation of the incidence of adverse drug reactions (ADRs), and a few studies have been conducted in community settings, particularly in community pharmacies. This study aimed to determine the frequency and characteristics of short-term ADRs associated with ibuprofen and diclofenac in community pharmacy patients.

Methods

This prospective cohort study was conducted in 15 community pharmacies. A questionnaire from a previous study was modified and tested for content validity. Community pharmacists distributed the questionnaire after dispensing ibuprofen or diclofenac and followed non-responders via telephone and online media platforms. The returned questionnaires were assessed for causality by a pharmacist and three researchers. Descriptive analyses and comparisons between reports on ibuprofen and diclofenac were performed using chi-square and independent t-tests for appropriate outcomes.

Results

Of the 590 distributed questionnaires, 279 were included in the analysis. The percentage of participants who reported ADRs to ibuprofen and diclofenac was 33.3%. Among participants with suspected ADRs, the average number of suspected ADRs from diclofenac was higher than from ibuprofen; however, no significant difference was observed (5.5 ± 8.9 and 3.1 ± 3.0, p > 0.05). Of the 347 self-reported ADRs, 45.2% were assessed as probable and possible ADRs. The highest rate of suspected ADRs was in Mental Health (14.4%), followed by the Nose, Throat, Neck, or Voice (9.8%), and the Stomach or Digestive Systems (8.9%), respectively.

Conclusions

Diclofenac showed more suspected ADRs than ibuprofen in a community setting. Almost half of the self-reported ADRs were assessed as probable or possible. Strategies for sustaining community pharmacists in monitoring patients and reporting ADRs should be supported.

Prevalence, awareness, and patterns of non-steroidal anti-inflammatory drug use among health science students in Palestine: a cross-sectional study

Despite the widespread use of nonsteroidal anti-inflammatory drugs (NSAIDs), many people lack sufficient awareness regarding their side effects and proper usage. Consequently, this study aimed to assess the knowledge, behavior, and usage patterns of NSAIDs among students enrolled in Palestinian health colleges. The study was conducted in December 2020 using a cross-sectional design, and a convenience sampling method was employed to enroll a total of 206 students. The questionnaire comprised seven sections, each containing approximately 5 to 10 closed-ended questions. Data were analyzed using version 21 of the Statistical Package for the Social Sciences (IBM-SPSS Statistics 21). The percentage of respondents who admitted that NSAIDs were used several times in the year was 35.9%. More than half of the students believed that NSAIDs were generally safe. Seventy-two percent of the students were aware that more than one type of NSAID at the same time increased the side effects. The median knowledge score of NSAID side effects was 9 [6.25-11] out of 13. The knowledge score increased significantly with age (p < 0.001), higher academic year (p < 0.001), and pharmacy and medicine specialties (p = 0.002). The college students surveyed in this study possess a general awareness of NSAIDs. Nonetheless, there remains a necessity to enhance their behavior and practices concerning the utilization of NSAIDs through the implementation of programmed educational strategies.

An Analysis of Judicial Cases Concerning Analgesic-Related Medication Errors in the Republic of Korea

OBJECTIVES

Analgesic-related medication errors can be a threat to patient safety. This study aimed to identify and describe medication errors that can cause serious adverse drug events (ADEs) related to analgesic use.

METHODS

This retrospective, observational, medicolegal study analyzed closed cases concerning complications induced by medication errors involving 3 commonly used analgesics: opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen (AAP). Cases closed between 1994 and 2019 that were available in the Korean Supreme Court judgment database system were included. Medication errors were categorized using a classification system (developed by our group) based on the stage of drug administration. Clinical characteristics and judgment statuses were analyzed.

RESULTS

A total of 71 cases were included in the final analysis (opioids, n = 30; NSAIDs, n = 35; AAP, n = 6). Among them, 43 claims (60.6%) resulted in payments to the plaintiffs, with a median payment of $86,607 (interquartile range, $34,554-$193,782). The severity of ADEs was high (National Association of Insurance Commissioners scale ≥6) in 88.7% (n = 63) of claims, with a total of 44 (62%) deaths. The most common types of ADEs associated with opioid, NSAID, and AAP use were respiratory depression, anaphylactic shock, and fulminant hepatitis, respectively. The most common recognized medication errors associated with opioid, NSAIDs, and AAP were inappropriate patient monitoring (n = 10; 33.3%), improper analgesic choice (n = 15; 42.9%), and inappropriate treatment after ADEs (n = 3; 50%), respectively.

CONCLUSIONS

Our findings indicate that efforts should be made to reduce medication errors related to analgesic use to prevent permanent injury and potential malpractice claims.

Survey on Tunisian Dentists' Anti-Inflammatory Drugs' Prescription in Dental Practice

Dentists prescribe several types of drugs such as anti-inflammatory medicines in their practice in order to manage pain. An adequate knowledge of anti-inflammatory drugs' characteristics is mandatory for a reasonable prescription to ensure patients safety. The study aimed to describe dentists' anti-inflammatory drugs prescription in dental practice. Materials and Methods. This study was conducted on independent practice dentists working in the region of Tunis. A questionnaire was made on “Google forms” and sent to all of them via personal emails. The questionnaire included demographic data and 13 questions about anti-inflammatory medicines: indications and contraindications, the side effects, and their prescription in dental practice. Data analysis was performed on SPSS software version 20.0 (trial version), using the χ2 test for statistical analysis. Results. Two hundred dentists participated to the survey. The female gender was predominant (70%). More than half of the responders were recently graduated and working in their own dental offices. The present study showed that 60% of dentists rarely prescribe anti-inflammatory drugs. Ibuprofen was prescribed by 82% of the dentists. Next came dexamethasone acetate (68.2%). The most frequent indication was postoperative pain (65%). Gastric problem was found to be the most mentioned adverse effect (69%). Thus, 72% of the dentists prescribed proton pump inhibitors with AI. Conclusion. According to this study, dentists have a lack of knowledge and awareness about some contraindications, side effects, and drugs interactions. Thus, knowledge updating, practices assessment, and continuous education are always required to avoid drug iatrogenesis.