Evaluation of drug utilization and prescribing practices in osteoarthritis patients: insights from a prospective observational study

Authors

  • Panchal V. Jagdishbhai Indubhai Patel College of Pharmacy and Research Centre, Dharmaj, Anand, Gujarat, India
  • Rana K. Jagdishbhai Indubhai Patel College of Pharmacy and Research Centre, Dharmaj, Anand, Gujarat, India
  • Patel U. Pravinbhai Indubhai Patel College of Pharmacy and Research Centre, Dharmaj, Anand, Gujarat, India
  • Vegad D. Bharatbhai Indubhai Patel College of Pharmacy and Research Centre, Dharmaj, Anand, Gujarat, India
  • Patel H. Sanjaykumar Department of Pharmacy Practice, Indubhai Patel College of Pharmacy and Research Centre, Dharmaj, Anand, Gujarat, India
  • Dharmendra S. Rajput Department of Pharmacy Practice, Indubhai Patel College of Pharmacy and Research Centre, Dharmaj, Anand, Gujarat, India
  • Sangita Shukla Indubhai Patel College of Pharmacy and Research Centre, Dharmaj, Anand, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20262645

Keywords:

Osteoarthritis, Prescribing patterns, Drug utilization, Polypharmacy, NSAIDs, WHO prescribing indicators, Rational drug use

Abstract

Background: Osteoarthritis (OA) is a common chronic musculoskeletal disorder associated with pain, disability, and frequent medication use. Objective of the study was to evaluate prescribing patterns, WHO prescribing indicators, comorbidities, and treatment practices in OA patients.

Methods: A six-month prospective observational study included 270 OA patients at a tertiary care hospital in Gujarat, India. Demographic, clinical, and prescribing data were analyzed using WHO prescribing indicators and two-way ANOVA.

Results: Females constituted 73.7% of patients, and knee OA was most common (90.7%). Combination therapy (66.2%) was prescribed more often than monotherapy. Oral NSAIDs were the most frequently used drugs, followed by tramadol-acetaminophen. Hypertension was the leading comorbidity. BMI and comorbidities were significantly associated with OA severity (p=0.0091 and p=0.0003, respectively). Generic prescribing (3.62%) and essential medicine use (4.69%) were low.

Conclusions: NSAIDs remain the primary treatment, but high polypharmacy and poor adherence to rational prescribing indicators emphasize the need for guideline-based prescribing to improve patient outcomes.

References

DiPiro JT, Yee GC, Posey LM, Haines ST, Nolin TD, Ellingrod V. Pharmacotherapy: a Pathophysiologic Approach. 10th Edition. McGraw Hill Medical. 2020.

Yunus MHM, Nordin A, Kamal H. Pathophysiological perspective of osteoarthritis. Medicina. 2020;56(11):614.

Jang S, Lee K, Ju JH. Recent updates of diagnosis, pathophysiology, and treatment on osteoarthritis of the knee. Int J Mol Sci. 2021;22(5):2619.

Arthritis Foundation. Osteoarthritis: Symptoms, diagnosis, and treatment. Available at: https://www. arthritis.org/diseases/osteoarthritis. Accessed on 15 May 2026.

Marshall DA, Liu X, Barnabe C, Yee K, Faris PD, Barber C, et al. Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada. BMJ Open. 2019;9(11):e033334.

Swain S, Sarmanova A, Coupland C, Doherty M, Zhang W. Comorbidities in Osteoarthritis: A Systematic Review and Meta‐Analysis of Observational Studies. Arthritis Care Res. 2019;72(7):991-1000.

Li B, Yang Z, Li Y, Zhang J, Li C, Lv N. Exploration beyond osteoarthritis: the association and mechanism of its related comorbidities. Front Endocrinol. 2024;19:15.

Nedunchezhiyan U, Varughese I, Sun AR, Wu X, Crawford R, Prasadam I. Obesity, inflammation, and immune system in osteoarthritis. Front Immunol. 2022;4:13.

American College of Rheumatology. Osteoarthritis Clinical Practice Guidelines. Available at: https://rheu matology.org/osteoarthritis-guideline. Accessed on 15 May 2026.

Richard MJ Jr, Driban JB, McAlindon TE, Osteoarthritis Research Society International. Pharmaceutical treatment of osteoarthritis. Osteoarthritis and Cartilage. 2023;31:458-66.

Sah G, Malla B. Analysis of prescribing patterns of drugs used in osteoarthritis in Tertiary Care center. J Drug Delivery Ther. 2024;14(10):10-7.

Samant PD, Patil M, Khan AS, Gupta P, Dubey L, Thakare V. Evaluating prescription Patterns and drug Utilization Trends in Orthopedic Care: a Prospective Observational study. Int J Pharm Clin Res. 2024;16(3):1489-94.

World Health Organization. How to investigate drug use in health facilities: selected drug use indicators. 1993. Available at: https://iris.who.int/handle/ 10665/60519. Accessed on 15 May 2026.

Abhilash S A, Rao RR, Yadunath SP. Assessment of prescribing pattern among orthopedic in-patients using who prescribing indicators. Asian J Pharm Clin Res. 2018;11(12):505.

Ministry of Health & Family Welfare. Standard Treatment Guidelines management of osteoarthritis knee. 2017. Available at: http://clinicalestablish ments.gov.in/WriteReadData/31911.pdf. Accessed on 15 May 2026.

Ummat NA, Singh NRJ, Kochhar NS. An observational study of prescription pattern of drugs for osteoarthritis in a north Indian medical college. Asian J Pharm Clin Res. 2019;14:308-10.

Abhilash S A, Rao RR, Yadunath SP. Assessment of prescribing pattern among orthopedic in-patients using who prescribing indicators. Asian J Pharm Clin Res. 2018;11(12):505.

Kumar M, Dutta S, Sharma J, Lote VB. A study of prescription pattern of drugs used in the treatment of osteoarthritis in tertiary care teaching hospitals. Int J Health Sci. 2022;18:9400-11.

Ide J, Shoaibi A, Wagner K, Weinstein R, Boyle KE, Myers A. Patterns of Comorbidities and Prescribing and Dispensing of Non-steroidal Anti-inflammatory Drugs (NSAIDs) Among Patients with Osteoarthritis in the USA: Real-World Study. Drugs Aging. 2024;41(4):357-66.

Rajamäki TJ, Puolakka PA, Hietaharju A, Moilanen T, Jämsen E. Use of prescription analgesic drugs before and after hip or knee replacement in patients with osteoarthritis. BMC Musculoskeletal Disorders. 2019;14:20.

Varagani S, Safwan M, Makutam V, Dhiraj K. A comparative study on assessment of safety and efficacy of Diclofenac, Naproxen and Etoricoxib in reducing pain in osteoarthritis patients - An observational study. Int J Curr Res Med Sci. 2024;10(8):31-8.

Zapata A, Fernández-Parra R. Management of Osteoarthritis and Joint Support Using Feed Supplements: A Scoping Review of Undenatured Type II Collagen and Boswellia serrata. Animals. 2023;13(5):870.

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Published

2026-07-30

How to Cite

Jagdishbhai, P. V., Jagdishbhai, R. K., Pravinbhai, P. U., Bharatbhai, V. D., Sanjaykumar, P. H., Rajput, D. S., & Shukla, S. (2026). Evaluation of drug utilization and prescribing practices in osteoarthritis patients: insights from a prospective observational study. International Journal of Research in Medical Sciences, 14(8), 3512–3517. https://doi.org/10.18203/2320-6012.ijrms20262645

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Original Research Articles