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NSAID prescribing in older adults shows a high burden of polypharmacy, with celecoxib and aspirin frequently involved in potential drug–drug interactions that increase with comorbidity load and number of medications.
A prospective observational study from a secondary care hospital highlights substantial concerns around non-steroidal anti-inflammatory drug (NSAID) prescribing in older adults, revealing a high burden of polypharmacy and potential drug–drug interactions (pDDIs) in routine outpatient care. Analyzing electronic health records, Javedh Shareef and other researchers investigated 174 older adult patients who received NSAIDs through the outpatient pharmacy.
Prescribing patterns, polypharmacy, and pDDIs were systematically assessed via the Micromedex database, with statistical analyses exploring treatment-related risk factors. Celecoxib (28.2%) emerged as the most frequently prescribed oral NSAID, while ketoprofen (27.6%) was the leading topical NSAID. Importantly, aspirin and celecoxib were the NSAIDs most commonly implicated in pDDIs. Overall, the study identified 340 potential pDDIs, averaging 1.95 ± 3.66 interactions per prescription, underscoring the complexity of medication regimens in this population.
Polypharmacy exhibited a significant association with the presence of comorbidities, indicating that patients with multiple chronic conditions are particularly susceptible. Further analysis illustrated a strong positive link between the number of pDDIs and key treatment-related factors, including:
These findings emphasize that as disease complexity and medication counts rise, so does the likelihood of clinically relevant drug interactions. The study offers real-world evidence that NSAID prescribing in older adults is frequently accompanied by polypharmacy and a substantial likelihood of pDDIs. The authors stress the need for systematic medication screening, clinical decision-support tools, and targeted pharmacist or clinician interventions to optimize therapy, minimize avoidable risks, and ascertain safer, more valuable pain management in the aging population.
Clinical Interventions in Aging
Evaluation of Potential Drug–Drug Interactions, Polypharmacy, and Prescribing Patterns of NSAIDs Among the Older Adults in a Secondary Care Setting
Javedh Shareef et al.
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