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Prevalence and predictors of non-steroidal anti-inflammatory drug/analgesic therapeutic duplication in the South Korean ambulatory care setting

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Therapeutic duplication (TD) in prescriptions is a common cause of inappropriate drug use. This study aimed to determine the prevalence of TD in the Korean ambulatory setting and to determine the patient and prescriber characteristics that were associated with TD of non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics.

Methods

Ambulatory care cases with NSAID/analgesic prescriptions were extracted from the National Health Insurance database for January–March 2011. The Korean TD classification (64 ingredients) was used to define cases of TD. Multivariate logistic regression was used to determine the predictors of TD. The independent variables in the regression model included patient characteristics (sex, age, insurance type, comorbidity, diagnosis, and number of prescribed drugs) and prescriber characteristics (type of medical institution and specialty).

Results

Among 21 million patients, we identified 59,636,222 ambulatory care visits with NSAID/analgesic prescriptions; 13.3 % of these cases involved TD. The most frequent duplications were diclofenac/aceclofenac (12.4 % of TDs), diclofenac/talniflumate (11.2 %), and diclofenac/loxoprofen sodium (10.7 %). Male sex, older age, and a Charlson comorbidity index of ≥1 were associated with an increased likelihood of TD. Arthritis, injection administration (OR 3.676, 95 % CI 3.670–3.683), and the number of drugs per prescription were associated with an increased likelihood of TD. Orthopedic and pediatric specialties were associated with an increased likelihood of TD.

Conclusions

This study is the first to determine the prevalence of NSAID TD and the factors that were associated with its occurrence in South Korea. These results may help prevent TD and improve appropriate medication use.

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Author contributions

H.A.K. designed the study, performed the statistical analyses, and drafted the manuscript. S.M.L. reviewed literature and critically revised the manuscript. C.P. designed the study and performed the statistical analyses. D.S.K. contributed to the research question, study design, drafting, and final approval of the manuscript. D.S.K. is the guarantor of this work had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Funding

This study was partially funded by a research grant from the Health Insurance Review & Assessment Service in Korea.

Conflicts of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Health Insurance Review and Assessment Service, Hyoryeong-ro 267, Seocho-gu, Seoul, Korea

    Hyeun Ah Kang & Dong-Sook Kim

  2. Chung-Ang University College of Pharmacy, Heukseok-ro 84, Dongjak-gu, Seoul, Korea

    Seung-Mi Lee

  3. National Evidence based Healthcare Collaborating Agency, Toegye-ro 173, Jung-gu, Seoul, Korea

    Chanmi Park

Authors
  1. Hyeun Ah Kang
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  2. Seung-Mi Lee
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  3. Chanmi Park
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  4. Dong-Sook Kim
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Corresponding author

Correspondence to Dong-Sook Kim.

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Kang, H.A., Lee, SM., Park, C. et al. Prevalence and predictors of non-steroidal anti-inflammatory drug/analgesic therapeutic duplication in the South Korean ambulatory care setting. Eur J Clin Pharmacol 72, 109–116 (2016). https://doi.org/10.1007/s00228-015-1958-0

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  • DOI: https://doi.org/10.1007/s00228-015-1958-0

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