title: Determinants of self-medication with NSAIDs in a Portuguese community pharmacy.
abstract: BACKGROUND
  Non-steroid anti-inflammatory drugs (NSAIDs) are a widely used therapeutic group in the world, and particularly in the Portuguese population.
  
  
  OBJECTIVE
  To compare NSAID's use by prescription and self-medication acquisition and to determine the pattern of indication of NSAIDs, their usage profile and possible implications for patients' safety.
  
  
  METHODS
  A cross-sectional design was used where individuals presenting at a community pharmacy requesting NSAIDs during the study period (one month) were invited to answer a face-to-face interview where socio-demographic characteristics, the indication pattern and previous experience of side effects were assessed. A follow-up interview was performed one week later to assess the incidence of adverse effects. The study was ethically approved.
  
  
  RESULTS
  A sample of 130 NSAIDs users was recruited, comprising mostly women (n=87; 66.9%), actively employed (n=77; 59.2%) and presenting a mean age of 49.5 years old (SD=20.49). An equal proportion of individuals acquired NSAIDs by self-medication and with medical prescription (n=65; 50%). Over 4/5 of patients (n=57; 87.7%) acquiring NSAIDs without a prescription were self-medicated by their own initiative, and only 10.8% (n=7) had been advised by the pharmacist. The most commonly acquired active substances were ibuprofen and diclofenac. Self-medicated users more frequently resorted to topical NSAIDs following short term treatments. The major underlying condition motivating NSAIDs sought were musculoskeletal disorders (45.0%), regardless of the regimen. An important proportion of prevalent users of NSAIDs reported previous experience of adverse effects (11.3%). One week after initiating NSAID therapy, a small proportion of patients reported incidence of adverse effects.
  
  
  CONCLUSIONS
  Self-medication with NSAIDs is sought for numerous medical conditions. Reported adverse effects (prevalent and incident) confirm the need for a more rational use of NSAIDs and ongoing pharmacovigilance.
authors.affiliation: Center for Interdisciplinary Research Egas Moniz (CiiEM). Almada ( Portugal ). ana.pd.nunes@gmail.com.
authors.forename: Ana P
authors.initials: AP
authors.lastname: Nunes
authors.affiliation: Institute of Health Sciences Egas Moniz (ISCSEM). Center for Interdisciplinary Research Egas Moniz (CiiEM). Almada ( Portugal ). imargaridac@gmail.com.
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Costa
authors.affiliation: Institute of Health Sciences Egas Moniz (ISCSEM). Center for Interdisciplinary Research Egas Moniz (CiiEM). Almada ( Portugal ). Alvesdacosta.f@gmail.com.
authors.forename: Filipa A
authors.initials: FA
authors.lastname: Costa
keywords: Anti-Inflammatory Agents; Cross-Sectional Studies; Drug-Related Side Effects and Adverse Reactions; Non-Steroidal; Pharmacies; Portugal