Abstract

ASSESSMENT OF DRUG USE PATTERNS AND THERAPEUTIC APPROACHES IN JOINT PAIN: A CLINICAL PERSPECTIVE FOR PHARMACY PRACTICE-A PILOT STUDY

M. Jaya Gayathri^*, MD. Rubeena Kausar, L. Tejasri, M. Gowthami,Dr. C. R. Akila⁵ and Dr. M. Purushothaman

Abstract

Background: Joint pain is a prevalent musculoskeletal complaint associated with conditions such as osteoarthritis (OA), rheumatoid arthritis (RA), and gout. Effective pharmacological management plays a crucial role in improving functional outcomes, especially in resource-limited settings. This study aims to assess drug utilization patterns, polypharmacy prevalence, adverse drug reactions (ADRs), drug–drug interactions (DDIs), and adherence to standard guidelines in patients with joint pain. Methods: A prospective observational pilot study was conducted over six months in a tertiary care teaching hospital in Telangana, India. A total of 202 adult patients with clinically diagnosed joint pain were enrolled. Prescriptions were analyzed for drug classes, frequency, polypharmacy (≥5 drugs), potential DDIs (using Lexicomp®, Micromedex®, Medscape), ADRs (using WHO-UMC criteria), and adherence to ACR/NICE guidelines. Results: The majority of patients were aged 51–70 years (42.57%) with a female predominance (52.48%). A high prevalence of comorbidities (83.17%) was noted, particularly hypertension and diabetes. Analgesics and NSAIDs such as acetaminophen, tramadol, and aceclofenac were most frequently prescribed. Polypharmacy was observed in 44.55% of patients. Common potential DDIs included Tramadol + Acetaminophen and NSAIDs + antihypertensives. ADRs were reported in 2.48% of patients, primarily involving gastrointestinal and central nervous system effects. Adherence to ACR/NICE guidelines was high for NSAID use in OA (88.12%) but suboptimal for PPI co-prescription (59%) and DMARD use in RA (75%). Conclusion: The study highlights the complexity of joint pain pharmacotherapy, with prevalent polypharmacy and clinically relevant DDIs. While guideline adherence was generally satisfactory, gaps remain in gastroprotective strategies and disease-modifying therapies. These findings reinforce the critical role of clinical pharmacists in optimizing medication safety, ensuring rational prescribing, and enhancing adherence to treatment guidelines in joint pain management.

Keywords: Joint pain, drug utilization, polypharmacy, drug–drug interactions, adverse drug reactions, NSAIDs, DMARDs, ACR, NICE, clinical pharmacy.