title: High-risk use of over-the-counter non-steroidal anti-inflammatory drugs: a population-based cross-sectional study.
abstract: BACKGROUND
  The use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with serious adverse drug events (ADEs).
  
  
  OBJECTIVE
  To determine the prevalence of over-the-counter (OTC) NSAID use in the general population and in patients with a high risk of developing a serious NSAID-related ADE.
  
  
  METHODS
  Cross-sectional study in four general practices in the Netherlands.
  
  
  METHODS
  Two patient samples were selected: a random sample of adults (general population sample); and adult patients with a high risk of developing a serious ADE in case of NSAID use (high-risk sample). All included patients were sent a questionnaire regarding their use of OTC NSAIDs in the 4 weeks prior to participation.
  
  
  RESULTS
  In the general population sample, 118 of 456 (26%) invited patients completed the questionnaire. Of these, 35 (30%) had used an OTC NSAID. In the high-risk sample, 264 of 713 (37%) invited patients completed the questionnaire, and of these high-risk patients 33 (13%) had used an OTC NSAID. Over 20% of OTC NSAID users in the general population sample and over 30% in the high-risk sample had used the OTC NSAID for >7 days. OTC NSAIDs were used in a dosage exceeding the recommended daily maximum by 9% and 3% of OTC NSAID users in the general population and the high-risk sample respectively.
  
  
  CONCLUSIONS
  OTC NSAIDs are used by almost one-third of the general population. In the high-risk patients selected, one in eight patients used an OTC NSAID. Continued efforts by health authorities and healthcare professionals to inform patients of the risks of these drugs are warranted.
authors.affiliation: Department of General Practice;
authors.forename: Aafke R
authors.initials: AR
authors.lastname: Koffeman
authors.forename: Vera E
authors.initials: VE
authors.lastname: Valkhoff
authors.forename: Sevde
authors.initials: S
authors.lastname: Celik
authors.forename: Geert
authors.initials: G
authors.lastname: W't Jong
authors.forename: Miriam C J M
authors.initials: MC
authors.lastname: Sturkenboom
authors.forename: Patrick J E
authors.initials: PJ
authors.lastname: Bindels
authors.forename: Johan
authors.initials: J
authors.lastname: van der Lei
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D004366:Nonprescription Drugs / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs
keywords: anti-inflammatory agents, non-steroidal; general practice; over-the-counter drugs; primary care