PREVALENCE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) USE IN MALAYSIAN ADULTS AND ASSOCIATED FACTORS: A POPULATION-BASED SURVEY
DOI:
https://doi.org/10.37268/mjphm/vol.17/no.3/art.229Keywords:
non-steroidal anti-inflammatory drugs, NSAIDs use, NHMS, prevalence, MalaysiaAbstract
Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with adverse effects. However, NSAIDs are among the most popular pain killers and easily available over the counter. This study aimed to determine the prevalence of NSAIDs use in Malaysian adults and among those with chronic diseases such as arthritis, kidney disease, hypertension, heart disease and asthma. It also examined the factors associated with NSAIDs use. Data from the National Health Morbidity Survey (NHMS) 2011, a nation-wide survey was analysed. A total of 18231 respondents aged 18 years and above responded to this module. Multivariate logistic regression was used to investigate the association between NSAIDs use and associated factors. The overall prevalence of NSAIDs use among Malaysian adults was 14.2% (95%CI 13.3-15.1). Of the respondents, 4.2% (95%CI 3.8-4.7) took NSAIDs once daily. NSAIDs use was highly associated with those who were ever-told to have arthritis (aOR: 3.03; 95%CI 2.60-3.52) and have difficulty of performing daily activities or work (aOR: 2.06; 95%CI 1.86-2.28). Those who were ever-told to have kidney disease (aOR: 2.36; 95%CI 1.74-3.20), ever-told to have asthma (aOR: 1.36; 95%CI 1.17-1.58), ever-told to have heart disease (aOR: 1.34; 95%CI 1.08-1.65), known hypertension (aOR: 1.22; 95%CI 1.08-1.37) also were associated with NSAIDs use. By socio-demographic profiles, NSAIDs use was positively associated with those who have government benefit scheme or private health insurance (aOR: 1.44; 95%CI 1.31-1.58), higher education level (aOR: 1.35; 95%CI 1.20-1.51), higher household income (aOR: 1.26; 95%CI 1.11-1.44, aOR: 1.12; 95%CI 1.02-1.24), currently working (aOR: 1.25; 95%CI 1.13-1.39) and female (aOR: 1.17; 95%CI 1.07-1.28). NSAIDs use was less likely among those aged 60 years and above (aOR: 0.83; 95% CI 0.72-0.97), Chinese (aOR: 0.41; 95% CI 0.36-0.47) and ‘Others’ ethnicity (aOR: 0.82; 95% CI 0.67-0.99) compared to Malay ethnicity. NSAIDs use is prevalent in Malaysian adults and associated with co-morbidities and higher socio-demographic status, thus appropriate awareness should be promoted and highlighted in the community.
References
2. Botting R. Inhibitors of cyclooxygenases: mechanisms, selectivity and uses. J Physiol Pharmacol. 2006;57:113.
3. Rao P, Knaus EE. Evolution of nonsteroidal anti-inflammatory drugs (NSAIDs): cyclooxygenase (COX) inhibition and beyond. J Pharm Pharm Sci. 2008;11(2):81s–110s.
4. Haag G, Diener H-C, May A, et al. Self- medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche. J Headache Pain. 2011;12(2):201-217.
5. Hunt RH, Choquette D, Craig BN, et al. Approach to managing musculoskeletal pain. Can Fam Physician. 2007;53(7):1177-1184.
6. Koffeman AR, Valkhoff VE, Celik S, et al. High- risk use of over-the-counter non-steroidal anti- inflammatory drugs: a population-based cross- sectional study. Br J Gen Pract J R Coll Gen Pract. 2014;64(621):e191-198.
7. Wilcox CM, Cryer B, Triadafilopoulos G. Patterns of use and public perception of over- the-counter pain relievers: focus on nonsteroidal antiinflammatory drugs. J Rheumatol. 2005;32(11):2218-2224.
8. Fosbøl EL, Gislason GH, Jacobsen S, et al. The pattern of use of non-steroidal anti- inflammatory drugs (NSAIDs) from 1997 to 2005: a nationwide study on 4.6 million people. Pharmacoepidemiol Drug Saf.
9. Ferraz-Amaro I, Machín S, Carmona L, et al. Pattern of use and safety of non-steroidal anti- inflammatory drugs in rheumatoid arthritis patients. A prospective analysis from clinical practice. Reumatol Clin. 2009;5(6):252-258.
10. Gnjidic D, Blyth FM, Le Couteur DG, et al. Nonsteroidal anti-inflammatory drugs (NSAIDs) in older people: Prescribing patterns according to pain prevalence and adherence to clinical guidelines. PAIN®. 2014;155(9):1814-1820.
11. Adams RJ, Appleton SL, Gill TK, et al. Cause for concern in the use of non-steroidal anti- inflammatory medications in the community -a population-based study. BMC Fam Pract. 2011;12(1):70.
12. Institute for Public Health (IPH). National Health and Morbidity Survey 2011 (NHMS 2011). Vol. 1: Methodology and General Findings; 2011: 258 Pages. Kuala Lumpur: Ministry of Health Malaysia; 2011.
13. Turunen JHO, Mäntyselkä PT, Kumpusalo EA, et al. Frequent analgesic use at population level: prevalence and patterns of use. Pain. 2005;115(3):374-381.
14. Zhou Y, Boudreau DM, Freedman AN. Trends in the use of aspirin and nonsteroidal anti- inflammatory drugs in the general U.S. population. Pharmacoepidemiol Drug Saf. 2014;23(1):43–50.
15. Plantinga L, Grubbs V, Sarkar U, et al. Nonsteroidal Anti-Inflammatory Drug Use Among Persons With Chronic Kidney Disease in the United States. Ann Fam Med. 2011;9(5):423-430.
16. van Laar M, Pergolizzi JV, Mellinghoff H-U, et al. Pain Treatment in Arthritis-Related Pain: Beyond NSAIDs. Open Rheumatol J. 2012;6:320-330.
17. Fendrick AM, Greenberg BP. A review of the benefits and risks of nonsteroidal anti- inflammatory drugs in the management of mild-to-moderate osteoarthritis. Osteopath Med Prim Care. 2009;3(1):1.
18. Ely LS, Engroff P, Guiselli SR, et al. Use of anti-inflammatory and analgesic drugs in an elderly population registered with a Family Health Program Luísa. Rev Bras Geriatr E Gerontol. 2015;18(3):475-485.
19. Shah S, Mehta V. Controversies and advances in non-steroidal anti-inflammatory drug (NSAID) analgesia in chronic pain management. Postgrad Med J. 2012;88(1036):73-78. doi:10.1136/postgradmedj-2011-130291.
20. Fowler TO, Durham CO, Planton J, et al. Use of nonsteroidal anti-inflammatory drugs in the older adult: Use of NSAIDs in older adults. J Am Assoc Nurse Pract. 2014;26(8):414-423.
21. Pokela N, Bell JS, Lihavainen K, et al. Analgesic use among community-dwelling people aged 75 years and older: a population- based interview study. Am J Geriatr Pharmacother. 2010;8(3):233–244.
22. Sostres C, Gargallo CJ, Lanas A. Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage. Arthritis Res Ther. 2013;15(Suppl 3):S3.
23. Marcum ZA, Hanlon JT. Recognizing the risks of chronic nonsteroidal anti-inflammatory drug use in older adults. Ann Long-Term Care Off J Am Med Dir Assoc. 2010;18(9):24.
24. Dale O, Borchgrevink PC, Fredheim OMS, et al. Prevalence of use of non-prescription analgesics in the Norwegian HUNT3 population: Impact of gender, age, exercise and prescription of opioids. BMC Public Health. 2015;15(1).
25. Goodin B, Bulls H, Freeman E, et al. Sex differences in experimental measures of pain sensitivity and endogenous pain inhibition. J Pain Res. June 2015:311.
26. Ramírez-Maestre C, Esteve R. The role of sex/gender in the experience of pain: Resilience, fear, and acceptance as central variables in the adjustment of men and women with chronic pain. J Pain. 2014;15(6):608-618.
27. Fillingim RB, King CD, Ribeiro-Dasilva MC, et al. Sex, Gender, and Pain: A Review of Recent Clinical and Experimental Findings. J Pain Off J Am Pain Soc. 2009;10(5):447-485.
28. Wu AP, Burke A, LeBaron S. Use of traditional medicine by immigrant Chinese patients. Fam Med-Kans CITY-. 2007;39(3):195.