Aafke R Koffeman1, Amanda R Van Buul1, Vera E Valkhoff2,3, Geert W 't Jong2,4, Patrick J E Bindels1, Miriam C J M Sturkenboom2,5, Johan Van der Lei2, Pim A J Luijsterburg1, Sita M A Bierma-Zeinstra1,6. 1. a Department of General Practice , Erasmus University Medical Center , Rotterdam , The Netherlands. 2. b Department of Medical Informatics , Erasmus University Medical Center , Rotterdam , The Netherlands. 3. c Department of Gastroenterology and Hepatology , Erasmus University Medical Center , Rotterdam , The Netherlands. 4. d Department of Paediatrics & Child Health , University of Manitoba , Winnipeg MB , Canada. 5. e Department of Epidemiology , Erasmus University Medical Center , Rotterdam , The Netherlands. 6. f Department of Orthopedic Surgery , Erasmus University Medical Center , Rotterdam , The Netherlands.
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). DESIGN: Cohort study. SETTING: A healthcare database containing the electronic GP medical records of over 1.5 million patients throughout the Netherlands. PATIENTS: A total of 16 626 adult patients with MSK complaints prescribed an NSAID. MAIN OUTCOME MEASURES: 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). CONCLUSION: 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.
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). DESIGN: Cohort study. SETTING: A healthcare database containing the electronic GP medical records of over 1.5 million patients throughout the Netherlands. PATIENTS: A total of 16 626 adult patients with MSK complaints prescribed an NSAID. MAIN OUTCOME MEASURES: 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). CONCLUSION: 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.
Entities:
Keywords:
Anti-inflammatory agents; The Netherlands; drug toxicity; general practice; musculoskeletal/connective tissue; non-steroidal; pharmacoepidemiology; primary health care
Authors: A E Vlug; J van der Lei; B M Mosseveld; M A van Wijk; P D van der Linden; M C Sturkenboom; J H van Bemmel Journal: Methods Inf Med Date: 1999-12 Impact factor: 2.176
Authors: J van der Lei; J S Duisterhout; H P Westerhof; E van der Does; P V Cromme; W M Boon; J H van Bemmel Journal: Ann Intern Med Date: 1993-11-15 Impact factor: 25.391
Authors: C A Naranjo; U Busto; E M Sellers; P Sandor; I Ruiz; E A Roberts; E Janecek; C Domecq; D J Greenblatt Journal: Clin Pharmacol Ther Date: 1981-08 Impact factor: 6.875
Authors: Kimberly G Blumenthal; Kenneth H Lai; Mingshu Huang; Zachary S Wallace; Paige G Wickner; Li Zhou Journal: J Allergy Clin Immunol Pract Date: 2017-01-18
Authors: Faizah Safina Bakrin; Mohd Makmor-Bakry; Wan Hazmy Che Hon; Shafeeq Mohd Faizal; Mohamed Mansor Manan; Long Chiau Ming Journal: Pharmacy (Basel) Date: 2020-12-08