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. 2020 Apr-Jun;19(2):131-136.
doi: 10.4103/aam.aam_57_19.

Evaluation of prescription pattern of analgesic use among ambulatory elderly in South-Western Nigeria

Wuraola Akande-Sholabi  1 , Princess C Agha  1 , Olufemi O Olowookere  2 , Lawrence A Adebusoye  2
Affiliations

Evaluation of prescription pattern of analgesic use among ambulatory elderly in South-Western Nigeria

Wuraola Akande-Sholabi et al. Ann Afr Med. 2020 Apr-Jun.

Abstract
in English, French

Background: Inappropriate prescribing of analgesics has a global impact on the health of elderly patients and the society. Empirical evidence on the prescription of analgesics among elderly Nigerians is scarce.

Objectives: The objective of the study was to evaluate the prescription pattern of analgesics and describe the co-prescribing of gastroprotective agents with non-steroidal anti-inflammatory drugs (NSAIDs) among elderly patients at the geriatric center, University College Hospital, Ibadan.

Methods: A retrospective cross-sectional, hospital-based study was carried out among elderly patients (≥60 years) who were prescribed analgesics. Using a data extraction sheet, information on demographic characteristics, drug utilization pattern, and morbidities was obtained from patients' case files via electronic health records.

Results: A total of 337 patients case files were reviewed, the mean age was 72 ± 8.8 years, and 210 (62.3%) were females. There were a total of 2074 medications prescribed, with 733 (35.3%) being analgesics. Majority of the elderly patients (259, 76.9%) were on nonopioids, with 252 (74.8%) on NSAIDs. Paracetamol was the most commonly prescribed analgesics (181, 24.6%), followed by diclofenac/misoprostol (177, 24.1%), opioid analgesic prescribed was 88 (12.0%), with paracetamol/codeine 58 (65.9%), and tramadol 16 (18.2%) being the most prescribed opioid. A significant proportion of the hypertensive elderly patients (160, 78.8%; P < 0.036) were on NSAIDs. The oral route of administration (302, 89.6%) was the most common route of administration. Majority (310, 92%) of elderly patients taking NSAIDs had a co-prescription for gastroprotective agents.

Conclusions: Majority of hypertensive patients were on NSAIDs. This calls for prompt awareness of rational analgesic use among the elderly to improve management and their survival.

RésuméContexte: La prescription inappropriée d'analgésiques a un impact mondial sur la santé des patients âgés et la société. Les preuves empiriques sur la prescription d'analgésiques chez les Nigérians âgés sont rares. Objectifs: L'objectif de l'étude était d'évaluer le schéma de prescription des analgésiques et de décrire la co-prescription d'agents gastroprotecteurs avec des anti-inflammatoires non stéroïdiens (AINS) chez les patients âgés du centre gériatrique, University College Hospital, Ibadan. Méthodes: Une étude rétrospective transversale en milieu hospitalier a été menée auprès de patients âgés (≥ 60 ans) à qui l'on avait prescrit des analgésiques. À l'aide d'une feuille d'extraction de données, des informations sur les caractéristiques démographiques, le mode d'utilisation des médicaments et les morbidités ont été obtenues à partir des dossiers des patients via les dossiers de santé électroniques. Résultats: Un total de 337 dossiers de patients ont été examinés, l'âge moyen était de 72 ± 8,8 ans et 210 (62,3%) étaient des femmes. Au total, 2074 médicaments ont été prescrits, dont 733 (35,3%) étaient des analgésiques. La majorité des patients âgés (259, 76,9%) étaient sous nonopioïdes, avec 252 (74,8%) sous AINS. Le paracétamol était l'analgésique le plus couramment prescrit (181, 24,6%), suivi du diclofénac / misoprostol (177, 24,1%), l'analgésique opioïde prescrit était de 88 (12,0%), avec le paracétamol / codéine 58 (65,9%) et le tramadol 16 (18,2%) étant l'opioïde le plus prescrit. Une proportion importante des patients âgés hypertendus (160, 78,8%; P <0,036) étaient sous AINS. La voie d'administration orale (302, 89,6%) était la voie d'administration la plus courante. La majorité (310, 92%) des patients âgés prenant des AINS avaient une co-prescription d'agents gastroprotecteurs. Conclusions: La majorité des patients hypertendus étaient sous AINS. Cela nécessite une prise de conscience rapide de l'utilisation rationnelle des analgésiques chez les personnes âgées pour améliorer la prise en charge et leur survie.

Keywords: Analgesic; elderly; nonsteroidal anti-inflammatory drugs; prescription pattern; proton pump inhibitors.

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