<![CDATA[Background: Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are among the most frequently prescribed medications for managing pain and inflammation. Uncontrolled NSAID use poses a risk of serious health issues, particularly in elderly patients with comorbidities. The Siwuluh Community Health Center (Puskesmas) in Brebes Regency serves a significant elderly population with musculoskeletal complaints who frequently use NSAID therapy. This study aimed to evaluate the rationality of NSAID use, specifically regarding the appropriateness of indications, patient selection, drug choice, dosage, and monitoring for side effects. Methods: This was a non-experimental, descriptive study utilizing a retrospective quantitative approach. Data were collected from the outpatient medical records at the Siwuluh Community Health Center, Brebes Regency, for the year 2025. A purposive sampling technique was employed to select 110 respondents who met the inclusion criteria (aged 60–74 years, female, and having comorbidities). Rationality was evaluated by comparing prescription and medical record data against the 2023 guidelines issued by the Indonesian Ministry of Health. Data were analyzed using univariate analysis, specifically frequency distribution and percentages. Results: Respondent characteristics showed that 100% were female, with the largest age group being 60–64 years (53.6%). Hyperuricemia was the most prevalent comorbidity (54.5%). Mefenamic acid 500 mg was the most frequently prescribed NSAID (40.0%). The rationality evaluation revealed the following rates of appropriateness: indication (100.0%), patient selection (89.1%), drug choice (85.5%), and dosage (85.5%). Regarding side effect monitoring, 91.8% of cases required clinical attention due to the absence of gastroprotective agents. The analysis of irrationality revealed a 10.9% rate of contraindications and a 14.5% rate of dual NSAID combinations.]]>
