Article date: May 2014
By: Mai Duong, Francesco Salvo, Antoine Pariente, Abdelilah Abouelfath, Regis Lassalle, Cecile Droz, Patrick Blin, Nicholas Moore, in Volume 77, Issue 5, pages 887-895
Aims
Most risks of nonsteroidal anti‐inflammatory drugs (NSAIDs) are pharmacological, dose and duration dependent. Usage patterns of prescription‐only (POM) or ‘over‐the‐counter (OTC)’ NSAIDs may influence risks, but are not commonly described.
Methods
The Echantillon Généraliste de Bénéficiaires database, the permanent 1/97 representative sample from the French national healthcare insurance systems, was queried over 2009–2010 to identify usage patterns, concomitant chronic diseases and cardiovascular medication in OTC and POM NSAID users.
Results
Over 2 years, 229 477 of 526 108 patients had at least one NSAID dispensation; 44 484 patients (19%) were dispensed only OTC NSAIDs (93% ibuprofen) and 121 208 (53%) only POM NSAIDs. The OTC users were younger (39.9 vs. 47.4 years old) and more often female (57 vs. 53%); 69% of OTC users and 49% of POM users had only one dispensation. A mean of 14.6 defined daily doses (DDD) were dispensed over 2 years for OTC vs. 53 for POM; 93% OTC vs. 60% POM patients bought ≤ 30 DDD over 2 years, and 1.5 vs. 12% bought ≥ 90 DDD. Chronic comorbidities were found in 19% of OTC users vs. 28% of POM users; 24 vs. 37% had at least one dispensation of a cardiovascular drug over the 2 years.
Conclusions
Most of the use of NSAIDs appears to be short term, especially for OTC‐type NSAIDs, such as ibuprofen. The validity of risk estimates for NSAIDs extrapolated from clinical trials or from observational studies not including OTC‐type usage may need to be revised.
DOI: 10.1111/bcp.12239
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