Pattern of NSAID use in the Italian general population: a questionnaire-based survey
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Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used medicines in the developed countries. The most important adverse reactions involve the upper gastrointestinal tract and can be life threatening. A detailed knowledge of the pattern of use of NSAIDs may help doctors in advising their patients about appropriateness and safety of use.
The aim of the present survey was to evaluate the prevalence and pattern of NSAID use in the general population, as well as the main characteristics of NSAID users.
Between March and September 2002, a self-administered questionnaire was submitted to a random sample, stratified by gender and age, representative of the Italian adult population (n=3,250). The questionnaire was divided into three parts regarding: (1) sociodemographic information, (2) symptoms/illnesses and (3) any drug taken during the previous week and the corresponding purpose. A statistical analysis (logistic regression) was performed.
Of the 2,738 subjects who filled in the questionnaire, 65% took at least one drug in the previous week and, among them, 35% used NSAIDs (top drug class; n=633). Of the NSAID users, 20% were ≥65 years of age and 18% were chronic users (daily or frequent use for more than 6 months). NSAID use was significantly higher in women, both for overall and chronic use. The older age groups showed an increasing risk of chronic NSAID use. Among NSAIDs, nimesulide was the most used compound (35%) followed by acetylsalicylic acid (14%) and ibuprofen (11%). The main reasons for NSAID use, as reported by subjects, were: headache (25%), osteoarticular pain (19%), unspecified pain (15%) and osteoarthrosis (9%). More than 50% of all the NSAIDs were prescribed by physicians (general practitioner, specialist, hospital physician), whereas about 44% were taken as self-treatment or following the advice of a pharmacist, relative/friend, etc.
Our study confirms that NSAIDs are widely used in the Italian general population and that, in most cases, they are used in accordance with their approved indications. However, their large and often chronic use in the elderly, as well as the high frequency of self-treatment, recommends a higher awareness by all physicians.
KeywordsNSAIDs Drug utilisation Questionnaire Chronic use
We wish to thank the Health Search coordinators Alessandro Bussotti and Ovidio Brignoli, and the GPs who participated in the study: Mauro Alba, Gregorio Baglioni, Mario Balduccelli, Antonio Barone, Pietro Bolentini, Emilio Mario Bove, Pierclaudio Brasesco, Carlo Buongiovanni, Paolo Carbonato, Antonio Caroselli, Roberto Cau, Antonio Ciriello, Giulio Corgatelli, Antonio Pompeo Coviello, Antonio De Bari, Giovanni De Cesare, Gerardo Decataldo, Giovanni Digiacomo, Alberto Dolci, Guido Endici, Tiziano Ermacora, Cinzia Farì, Carmine Marinaro, Serenella Fasulo, Pietro Diego Ferrara, Bruno Franco Novelletto, Nicola Gallicchio, Fabrizio Gangi, Elio Garaffa, Agnello Iaccarino, Alessandro Leso, Luciano Lippa, Serenella Longhi, Francesco Magliozzo, Gian Luca Mannari, Manuela Mariuz, Antonino Marsala, Carlo Fedele Marulli, Patrizia Mathieu, Vincenzo Maurici, Giovanni Merlino, Rosalba Murgia, Andrea Muscolo, Pasquale Orfanò, Italo Paolini, Lorenzo Passarini, Gionata Pessa, Patrizia Piano, Ernesto Pittana, Giuseppe Tubicini, Diego Sabbi, Marcello Salera, Giuliano Salvio, Antonio Santangelo, Margherita Santarsiero, Rita Clara Scaperrotta, Giuliana Simioni, Nicola Tarallo, Antonella Toselli, Gianni Tubaro, Marco Urago, Nicola Villani, Maria Vindigni, Piero Zaninetti, Alessandro Zennaro. We wish also to thank Claudio Voci for performing the statistical analysis. The study was supported by a research grant from Roche S.p.A., Italy
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