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. 2022 Feb 26;10(3):446.
doi: 10.3390/healthcare10030446.

Trends in Ambulatory Analgesic Usage after Myocardial Infarction: A Nationwide Cross-Sectional Study of Real-World Data

Sun-Young Jung  1 , Seung Yeon Song  2 , Eunyoung Kim  1   2   3
Affiliations

Trends in Ambulatory Analgesic Usage after Myocardial Infarction: A Nationwide Cross-Sectional Study of Real-World Data

Sun-Young Jung et al. Healthcare (Basel). .

Abstract

Although current guidelines for myocardial infarction (MI) recommend caution in using non-steroidal anti-inflammatory drugs (NSAIDs), real-world studies of ambulatory settings are rare. This study aimed to explore the patterns and trends of analgesic prescriptions (especially NSAIDs) among patients with a history of MI in ambulatory care settings in Korea. We analyzed real-world data from the Korea National Health Insurance Service database. Patients aged 20 years or older hospitalized with incident MI were identified between January 2007 and December 2015. Ambulatory analgesics were administered after discharge from incident hospitalization for MI, and annual trends in the prescriptions of individual analgesics were evaluated. Among the 93,597 patients with incident MI, 75,131 (80.3%) received a total of 2,081,705 ambulatory analgesic prescriptions. Prescriptions were mainly issued at primary care clinics (80.3%). Analgesics were most frequently prescribed for musculoskeletal diseases (often NSAIDs, 70.7%); aceclofenac (13.7%) and diclofenac injection (9.4%) were the frequently used NSAIDs. Additionally, significant changes were observed in the trends for some analgesics, such as loxoprofen. This study suggested that NSAIDs are commonly prescribed to patients with a history of MI. Future real-world studies are needed to elucidate the drug-disease interactions of NSAIDs prescribed after MI, especially for patients with musculoskeletal diseases.

Keywords: ambulatory analgesics; myocardial infarction; non-steroidal anti-inflammatory drugs (NSAIDs); patterns and trends; the Korea National Health Insurance Service (NHIS) database.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graphical depiction of the study design.
Figure 2
Figure 2
Trends and patterns of analgesic prescriptions with NSAIDs in ambulatory care settings among patients with a history of MI: (a) Type of medical institution and the number of analgesic prescriptions/patients. (b) The proportion of prescriptions with NSAIDs for each indication among patients with incident MI (2008–2015).
Figure 3
Figure 3
Time trends in the proportion of prescribed analgesics among patients with a history of MI during study years and time trend analysis (trends’ significance was expressed as beta value and p-value): (a) Overall trends in individual analgesics and (b) trends in musculoskeletal diseases (left: the proportions of the prescribed analgesics, right: time trends of individual analgesics). AAP: Acetaminophen, NS: Not Significant, tram: tramadol.
Figure 4
Figure 4
The proportions of non-steroidal anti-inflammatory drug (NSAID) prescriptions in analgesics for each indication among patients with a history of myocardial infarction.
See this image and copyright information in PMC

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