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Usage patterns of 'over-the-counter' vs. prescription-strength nonsteroidal anti-inflammatory drugs in France.


ABSTRACT:

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.

SUBMITTER: Duong M 

PROVIDER: S-EPMC4004409 | biostudies-literature | 2014 May

REPOSITORIES: biostudies-literature

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Publications

Usage patterns of 'over-the-counter' vs. prescription-strength nonsteroidal anti-inflammatory drugs in France.

Duong Mai M   Salvo Francesco F   Pariente Antoine A   Abouelfath Abdelilah A   Lassalle Regis R   Droz Cecile C   Blin Patrick P   Moore Nicholas N  

British journal of clinical pharmacology 20140501 5


<h4>Aims</h4>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.<h4>Methods</h4>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 diseas  ...[more]

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