Prevalence and Associated Factors of Non-Steroidal Anti ...

Prevalence and Associated Factors of Non-Steroidal Anti ...

Prevalence and Associated Factors of Non-Steroidal AntiInflammatory Drugs (NSAIDs) Used in Thai Rural Community Background In 2014, NSAIDs were prescribed more than 100 million times per year in USA. 29 million adults (12.1%) were regular NSAIDs user in USA. 2

Background CVS GI Renal 3 Background Thailand has used painkillers more than 67 % of the population in the country. More than 90% of GI bleeding cases were NSAIDs users. Information regarding NSAIDs used among Thai population is limited. 4

Background This is a very first study that provided essential information for the current and reliable database of NSAIDs used in Thai population. To improve the quality of patient health care services in the Thailand. 5 Objectives To determine prevalence of regular NSAIDs used

To identify associated factors for regular NSAIDs used To determine prevalence of adverse effects from NSAIDs used To determine prevalence of alternative pain killer drugs 6 Study design Cross-sectional Study Inclusion criteria

Aged 18 years in Exclusion criteria People who can not Bann nayao Village provide informed No. 11, 15, 16, 18, 19, consent. Sanam Chai Khet district, Chachoengsao Province, Thailand. 7 Data collection

Face to face questionnaire Questionnaire Approved by pharmacologists [IOC=1] Pilot was tested by 20 villagers Standardized test 8 Outcome of Interest Face to face questionnaire NSAIDs user or Not ? Yes No 9

Cross-sectional study design Regular NSAIDs used YES Use NSAIDs at least 3 times per week more than 3 months NO Associated factors Prevalence Age Gender Occupation Education

Medical condition Provider Other factors 10 Results General characteristic of study population (n=771) n (%) Gender Male Female Age (yr) * < 60 yr 60 yr *MeanSD(min-max) 282 (36.6) 489 (63.4) 52.414.3 (1899)

521 (61.6) 247 (32.0) 12 General characteristic of study population (n=771) n (%) Education Primary school Higher than primary school Uneducated 581 (75.4) 134 (17.4) 56 (7.3) Income (Baht/month) <5,000

394 (51.1) 5,000 377 (48.9) *40 baht=1.00 13 General characteristic of study population (n=771) n(%) Occupation Agriculture 294 (38.1) Unemployed 279 (36.2)

Others 198 (25.7) 14 Prevalence of NSAIDs used among 18 years old in Thai rural community (n = 771) Prevalence NSAIDs used 239(31.1%) Regular used 57(23.9%) Non regular used 182(76.1%) 15

Prevalence of alternative treatments(n=771) Alternative drugs n (%) Paracetamol Multiple drugs 490 (63.6) 92 (11.9) Muscle relaxants 44 (5.7) Opioids 23 (2.9) 16 Side effects of NSAIDs user

(n=239) Side effects n (%) Abdominal pain 56 (23.4) Dyspepsia 41 (17.2) Abdominal distention 34 (14.2) Melena 10 (4.2) 17

Univariate and multivariate analysis Univariate and multivariate for associated factors with regular NSAIDs used in Thai rural community (n=771) Non regular and non user Regular user Crude odds ratio n(%) n(%) 95%CI

95%CI Income 5,000 Baht <5,000 Baht 356(94.4) 358(90.9) 21(5.6) 36(9.1) 1 1.70 (0.98-2.98) 0.061 1 2.08 (1.07-4.06)

0.031 Pain at elbow No Yes 504(92.1) 24(80.0) 43(7.9) 6(20.2) 1 2.93 (1.14-7.56) 0.026 1 3.19

(1.18-8.65) 0.023 p -value Adjusted p-value odds ratio *Final model of multivariate analysis adjusted for Sex, Age, Incomes, Chronic kidney diseases, Peptic ulcers, Gouts, Osteoarthritis, Antihypertensive drugs user, Herbal user, Both side shoulder joints pain, Right elbow joint pain, Right wrist joint pain, Neck pain, Midback pain, Abdominal pain, Upper thigh pain and Pain score 19 Univariate and multivariate for associated factors with regular NSAIDs used in Thai rural community (n=771) Non regular and non user

Pain at hip/thigh No Yes Increasing Pain score Regular user Crude odds ratio n(%) n(%) 95%CI 95%CI 399(93.2)

129(86.6) 29(6.8) 20(13.4) 1 2.13 (1.17-3.9) 0.014 1 2.24 (1.19-4.21) 0.012 5.81(2.27) 7.06(2.11)

1.28 <0.001 1.24 0.002 (1.12-1.45) p-value Adjusted p-value odds ratio (1.08-1.43) *Final model of multivariate analysis adjusted for Sex, Age, Incomes, Chronic kidney diseases, Peptic ulcers, Gouts, Osteoarthritis, Antihypertensive drugs user, Herbal user, Both side shoulder joints pain, Right elbow joint pain, Right wrist joint pain, Neck pain,

Midback pain, Abdominal pain, Upper thigh pain and Pain score 20 Discussion The prevalence of regular NSAIDs used in rural community was 7.4%. Pain killers easily to assess Lack of awareness in adverse effects In USA, prevalence of regular NSAIDs used in hospital-based setting was 12.1%. 21 In USA, the associated factors In Thai rural community,

the associated factors - Age - Occupation - Gender - Education - Medical conditions - Provider - Income (<5,000 baht, OR: 2.08, 95%CI:1.074.06) - Medical conditions - Pain at elbow (OR:3.19,95%CI:1.188.65) - Pain at hip and thigh (OR: 2.24, CI:1.19-4.21) - Pain score (OR:1.24, CI:1.08-1.43) 22

Conclusion The prevalence of NSAIDs used in our study was nearly 1/3. The prevalence of regular NSAIDs used in a rural community was 7.4% The associated factors of regular NSAIDs used were income, pain at elbow, pain at hip and thigh and increasing pain score. 23 Recommendation For

the next study, this topic should be more widely covered in other communities. Health care policy especially life-style modification should be a primary way before using drugs. NSAIDs must be strictly prescribed according to the appropriateness. Increase awareness of the situation and risk factors of the problem from NSAIDs used in rural society of Thailand 24

Acknowledgement We gratefully acknowledge support for Department of Military and Community Medicine Department of Pharmacology Department of Rheumatology, Medicine Local village health volunteer Baan Na-Yao village and all participants for their help in this research

25 THANK YOU 26

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