BACKGROUND: Three types of non-steroidal anti-inflammatory drugs (NSAIDs) can be obtained both over the counter (OTC) and by prescription in the United States. OTC NSAID use is not recorded in prescription claims databases; this might lead to differential misclassification of NSAID exposure status in studies that use computerized pharmacy databases to study NSAID use. OBJECTIVE: To evaluate characteristics of OTC versus prescription NSAID users. METHODS: This analysis is set within the Multi-Ethnic Study of Atherosclerosis (MESA) study; a prospective cohort study of 6814 adults from four ethnic groups (European descent, Asian, African-American, and Hispanic) with a mean age of 62 years. The cohort was restricted to those who initiated NSAID use (aspirin, ibuprofen, or naproxen) during follow-up. We compared information about age, sex, ethnicity, body mass index, smoking, diabetes, medication use, education, income, health insurance status, and exercise between groups. RESULTS: OTC NSAID use was prevalent at baseline (25% aspirin, 9% ibuprofen, and 2% naproxen). Compared to prescribed NSAID use, OTC NSAID use was lower for users of non-European descent for all classes: aspirin (p < 0.0001), ibuprofen (p < 0.0001), and naproxen (p = 0.0094). For aspirin, differences were seen for male gender (relative risk (RR): 0.92; 95%confidence interval (CI): 0.86-0.98), use of lipid lowering drugs (RR: 0.88; 95%CI: 0.80-0.96), low income (RR: 0.89; 95%CI: 0.81-0.97), and participants one standard deviation above average in intentional exercise (RR: 1.03; 95%CI: 1.01-1.05). CONCLUSIONS: OTC NSAID use is prevalent in an older multi-ethnic population and OTC users differ from prescription NSAID users. Caution should be exercised when using prescribed NSAIDs as a proxy for NSAID use.
BACKGROUND: Three types of non-steroidal anti-inflammatory drugs (NSAIDs) can be obtained both over the counter (OTC) and by prescription in the United States. OTC NSAID use is not recorded in prescription claims databases; this might lead to differential misclassification of NSAID exposure status in studies that use computerized pharmacy databases to study NSAID use. OBJECTIVE: To evaluate characteristics of OTC versus prescription NSAID users. METHODS: This analysis is set within the Multi-Ethnic Study of Atherosclerosis (MESA) study; a prospective cohort study of 6814 adults from four ethnic groups (European descent, Asian, African-American, and Hispanic) with a mean age of 62 years. The cohort was restricted to those who initiated NSAID use (aspirin, ibuprofen, or naproxen) during follow-up. We compared information about age, sex, ethnicity, body mass index, smoking, diabetes, medication use, education, income, health insurance status, and exercise between groups. RESULTS: OTC NSAID use was prevalent at baseline (25% aspirin, 9% ibuprofen, and 2% naproxen). Compared to prescribed NSAID use, OTC NSAID use was lower for users of non-European descent for all classes: aspirin (p < 0.0001), ibuprofen (p < 0.0001), and naproxen (p = 0.0094). For aspirin, differences were seen for male gender (relative risk (RR): 0.92; 95%confidence interval (CI): 0.86-0.98), use of lipid lowering drugs (RR: 0.88; 95%CI: 0.80-0.96), low income (RR: 0.89; 95%CI: 0.81-0.97), and participants one standard deviation above average in intentional exercise (RR: 1.03; 95%CI: 1.01-1.05). CONCLUSIONS: OTC NSAID use is prevalent in an older multi-ethnic population and OTC users differ from prescription NSAID users. Caution should be exercised when using prescribed NSAIDs as a proxy for NSAID use.
Authors: Gary C Curhan; Andrea J Bullock; Susan E Hankinson; Walter C Willett; Frank E Speizer; Meir J Stampfer Journal: Pharmacoepidemiol Drug Saf Date: 2002-12 Impact factor: 2.890
Authors: T A Manolio; G L Burke; B M Psaty; A B Newman; M Haan; N Powe; R P Tracy; D H O'Leary Journal: J Clin Epidemiol Date: 1995-09 Impact factor: 6.437
Authors: Timothy S Anderson; Bocheng Jing; Charlie M Wray; Sarah Ngo; Edison Xu; Kathy Fung; Michael A Steinman Journal: Med Care Date: 2019-10 Impact factor: 2.983
Authors: Trang T Le; Rayus Kuplicki; Hung-Wen Yeh; Robin L Aupperle; Sahib S Khalsa; W Kyle Simmons; Martin P Paulus Journal: Biol Psychiatry Cogn Neurosci Neuroimaging Date: 2018-06-23
Authors: Meijia Zhou; Charles E Leonard; Colleen M Brensinger; Warren B Bilker; Stephen E Kimmel; Todd E H Hecht; Sean Hennessy Journal: Clin Pharmacol Ther Date: 2020-05-16 Impact factor: 6.875
Authors: Joseph A Delaney; Nils Lehmann; Karl-Heinz Jöckel; Sammy Elmariah; Bruce M Psaty; Amir A Mahabadi; Matt Budoff; Richard A Kronmal; Khurram Nasir; Kevin D O'Brien; Stefan Möhlenkamp; Susanne Moebus; Nico Dragano; Almut G Winterstein; Raimund Erbel; Hagen Kälsch Journal: Atherosclerosis Date: 2013-05-14 Impact factor: 5.162
Authors: Joanna M Rhodes; Vincent A LoRe; Anthony R Mato; Elise A Chong; Jacqueline C Barrientos; James N Gerson; Stefan K Barta; Daniel J Landsburg; Sunita Dwivedy Nasta; Jakub Svoboda; Alison W Loren; Stephen J Schuster Journal: Clin Lymphoma Myeloma Leuk Date: 2020-02-27
Authors: Kelly T Cosgrove; Rayus Kuplicki; Jonathan Savitz; Kaiping Burrows; W Kyle Simmons; Sahib S Khalsa; T Kent Teague; Robin L Aupperle; Martin P Paulus Journal: Brain Behav Immun Date: 2021-05-27 Impact factor: 19.227