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Nonsteroidal anti-inflammatory drugs (NSAIDs) have been found
to be associated with an elevated risk of peptic ulcer and
upper gastrointestinal hemorrhage. A retrospective cohort study
was performed to estimate the incidence and cumulative incidence
of serious ulcer disease among long-term users of NSAIDs, using
a computerized prescriprion data base of National Cheng-Kung
University Hospital. Twenty-eight thousand seven hundred and
seventy four NSAID recipients, who had NSAID prescription
record, were included. Three hundred and ten patients became the
study cases after medical record review and two hundred and
forty-two were interviewed via telephone. Incidence of serious
ulcer disease was between 11.7 per 1,000 person-year (95%
confidence interval 1.4-22.0) and 15.6 per 1,000 person-year
(95% confidence interval 1.9-29.3). Cumulative incidence of
serious ulcer disease was between 1.61% (95% confidence interval
0.53-3.72) and 2.07% (95% confidence interval 0.67-4.76). The
second objective in this study was to describe the prescribing
patterns of NSAIDs users. Osteoarthritis was the most commonly
listed indication. Among these NSAIDs, diclofenac SR was
prescribed most often in terms of defined daily dose. The
department of Orthopaedics prescribed the most of NSAIDs.
Within the limits of statistical error, the results of this
study was similar to that presented in previous reports. These
drugs should be used with caution, and alternatives to NSAIDs
should be strongly considered.
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