title: Adverse drug reactions in a primary care population prescribed non-steroidal anti-inflammatory drugs.
abstract: OBJECTIVE
  To determine how often patients with musculoskeletal (MSK) complaints prescribed a non-steroidal anti-inflammatory drug (NSAID) subsequently consult their general practitioner (GP) with a non-serious adverse drug reaction (ADR).
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  A healthcare database containing the electronic GP medical records of over 1.5 million patients throughout the Netherlands.
  
  
  METHODS
  A total of 16 626 adult patients with MSK complaints prescribed an NSAID.
  
  
  METHODS
  The patients' medical records were manually assessed for the duration of NSAID use for a maximum of two months, and consultations for complaints predefined as potential ADRs were identified. Subsequently, the likelihood of an association with the NSAID use was assessed and these potential ADRs were categorized as likely, possible, or unlikely ADRs.
  
  
  RESULTS
  In total, 961 patients (6%) consulted their GP with 1227 non-serious potential ADRs. In 174 patients (1%) at least one of these was categorized as a likely ADR, and in a further 408 patients (2.5%) at least one was categorized as a possible ADR. Dyspepsia was the most frequent likely ADR, followed by diarrhoea and dyspnoea (respectively 34%, 8%, and 8% of all likely ADRs).
  
  
  CONCLUSIONS
  Of the patients with MSK complaints prescribed an NSAID, almost one in 30 patients re-consulted their GP with a complaint likely or possibly associated with the use of this drug. The burden of such consultations for non-serious ADRs should be taken into account by GPs when deciding whether treatment with an NSAID is appropriate.
authors.affiliation: a Department of General Practice , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Aafke R
authors.initials: AR
authors.lastname: Koffeman
authors.affiliation: a Department of General Practice , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Van Buul
authors.affiliation: b Department of Medical Informatics , Erasmus University Medical Center , Rotterdam , The Netherlands.|c Department of Gastroenterology and Hepatology , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Vera E
authors.initials: VE
authors.lastname: Valkhoff
authors.affiliation: b Department of Medical Informatics , Erasmus University Medical Center , Rotterdam , The Netherlands.|d Department of Paediatrics & Child Health , University of Manitoba , Winnipeg MB , Canada.
authors.forename: Geert W 't
authors.initials: GW
authors.lastname: Jong
authors.affiliation: a Department of General Practice , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Patrick J E
authors.initials: PJ
authors.lastname: Bindels
authors.affiliation: b Department of Medical Informatics , Erasmus University Medical Center , Rotterdam , The Netherlands.|e Department of Epidemiology , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Miriam C J M
authors.initials: MC
authors.lastname: Sturkenboom
authors.affiliation: b Department of Medical Informatics , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Van der Lei
authors.affiliation: a Department of General Practice , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.affiliation: a Department of General Practice , Erasmus University Medical Center , Rotterdam , The Netherlands.|f Department of Orthopedic Surgery , Erasmus University Medical Center , Rotterdam , The Netherlands.
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D003967:Diarrhea / Q000209:etiology*; D064420:Drug-Related Side Effects and Adverse Reactions; D004415:Dyspepsia / Q000209:etiology*; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000188:drug therapy*; D011320:Primary Health Care; D012017:Referral and Consultation; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Anti-inflammatory agents; The Netherlands; drug toxicity; general practice; musculoskeletal/connective tissue; non-steroidal; pharmacoepidemiology; primary health care