NSAIDs Prescription Prevalence after a Cardiovascular Event Related Hospitalization in Medicaid Beneficiaries from Puerto Rico

Abstract

Objective: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation. NSAIDs are associated with serious adverse effects and cardiovascular (CV) risks that include myocardial infarction, stroke and heart failure. In the period of time immediately after a CV event, modification to the drug therapy regimen and lifestyle habits should be instituted to decrease morbidity and mortality. The objective of this study is to measure the prevalence of NSAIDs prescribing in the immediate 90 days after a CV-related hospitalization in Medicaid beneficiaries in Puerto Rico. Methods: Hospitalization claims were used to identify beneficiaries with a CVrelated hospitalization during the study period, and pharmacy claims were used to evaluate the occurrence of NSAIDs prescribing post-discharge. Results: A total of 4,195 beneficiaries with at least one CV-related hospitalization were identified. Out of these beneficiaries, 774 (18.5%) had at least one pharmacy claim for an NSAID post discharge, and 401 (9.6%) had at least one pharmacy claim for an NSAID within 90 days post-discharge. The average time span between the discharge date and the first NSAID claim was 135 days. Conclusion: Almost 20% of all beneficiaries who were hospitalized for a CV event received an NSAID during the study period, with 10% of patients receiving it during the immediate 90 days post-discharge. It represents a major challenge for our healthcare system, as it may reflect unawareness on the impact of proved evidence in clinical decision making.