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Gastro-intestinal problems and concomitant medication in NSAID users: additional findings from a questionnaire-based survey in Italy

  • Pharmacoepidemiology and Prescription
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Abstract

Background

In a previous questionnaire-based survey, we found extensive use of nonsteroidal anti-inflammatory drugs (NSAIDs) in subjects with risk factors for serious gastrointestinal complications.

Aim

This study focused on the use of NSAIDs in subjects who reported either (a) pre-existing disorders which would have required caution in using NSAIDs (e.g. dyspepsia/heartburn or peptic ulcer) or (b) co-medication with drugs having a high risk of interacting with NSAIDs.

Methods

Between March and September 2002, 65 general practitioners (GPs) submitted a validated self-administered questionnaire on health status and drug use to 3,250 subjects (age ≥18 years, stratified by sex and age). The questionnaire was divided into three parts: (1) sociodemographic information, (2) symptoms/illnesses (in the previous 6 months) and (3) drugs taken during the previous week.

Results

Of the 2,738 subjects who filled in the questionnaire (84% of responders), 633 (23%) used NSAIDs and, among them, 114 (18%) were chronic users. Among the subjects reporting dyspepsia/heartburn or ulcer (n=909 of 2,738), 24% were occasional NSAID users and 6% chronic users. Of the chronic NSAID users reporting gastrointestinal symptoms, 35% also used a drug for acid-related disorders, but only 14% used daily a proton pump inhibitor (PPI). One hundred six subjects used concomitantly more than one NSAID. Eighteen percent of the subjects using corticosteroids also reported NSAID use; similar proportions were seen in subjects using selective serotonin reuptake inhibitor (SSRI) antidepressants or calcium channel blockers, whereas 6% of the subjects with oral anticoagulants used NSAIDs.

Conclusions

Our study shows that NSAIDs are frequently used in patients with upper gastrointestinal complaints or in combination with potentially interacting medications. Adverse effects and untoward drug interactions should be monitored in patients treated with NSAIDs in order to minimise their occurrence.

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Acknowledgements

We wish to thank the Health Search coordinators Alessandro Bussotti, 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.

The study was supported by a research grant from Roche S.p.A., Italy.

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Authors and Affiliations

  1. Department of Pharmacology and Interuniversity Research Centre for Pharmacoepidemiology, University of Bologna, Bologna, Italy

    Maria Chiara Silvani, Domenico Motola, Elisabetta Poluzzi, Fabrizio De Ponti, Alberto Vaccheri & Nicola Montanaro

  2. Drug Safety, Roche SpA, Milan, Italy

    Ambrogio Bottoni

  3. Department of Pharmacology, Via Irnerio, 48, 40126, Bologna, BO, Italy

    Nicola Montanaro

Authors
  1. Maria Chiara Silvani
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  2. Domenico Motola
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  3. Elisabetta Poluzzi
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  4. Ambrogio Bottoni
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  5. Fabrizio De Ponti
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  6. Alberto Vaccheri
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  7. Nicola Montanaro
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Corresponding author

Correspondence to Nicola Montanaro.

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Silvani, M.C., Motola, D., Poluzzi, E. et al. Gastro-intestinal problems and concomitant medication in NSAID users: additional findings from a questionnaire-based survey in Italy. Eur J Clin Pharmacol 62, 235–241 (2006). https://doi.org/10.1007/s00228-005-0078-7

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  • DOI: https://doi.org/10.1007/s00228-005-0078-7

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