Deviations from evidence-based prescribing of non-steroidal anti-inflammatory drugs in three European regions


Objective: We examined to what extent the evidence of the relative gastrointestinal toxicity with non-steroidal anti-inflammatory drugs (NSAIDs) was implemented in clinical practice in Bologna, Italy, Funen, Denmark, and Stockholm, Sweden, areas with accurate computerised information on prescriptions purchased by defined populations. Methods: We ranked each NSAID by purchased volume in defined daily doses during September 1996 and compared it with the ranking of gastrointestinal complications from a meta-analysis of controlled epidemiological studies published between 1986 and 1994. We restricted our comparison to those NSAIDs that accounted for 90% of the use and within this DU90% segment we determined the proportion of “high risk” (azapropazone, ketoprofen, piroxicam) and “low risk” (ibuprofen, diclofenac) drugs with respect to gastrointestinal toxicity. Results: In Funen, Denmark, we found the best NSAID profile (63% low risk/11% high risk) while Bologna, Italy, had the other extreme (26% low risk/38% high risk), with Stockholm, Sweden, in between (43% low risk/20% high risk). Conclusion: Our study suggests that factors other than evidence-based medicine had a dominating impact on the use of prescription NSAIDs in 1996.

DOI: 10.1007/s002280000144

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@article{Bergman2000DeviationsFE, title={Deviations from evidence-based prescribing of non-steroidal anti-inflammatory drugs in three European regions}, author={U. Michael Bergman and M . I . Andersen and Alberto Vaccheri and Lars Bjerrum and Bj{\"{o}rn Wettermark and Nicola Montanaro}, journal={European Journal of Clinical Pharmacology}, year={2000}, volume={56}, pages={269-272} }