Cause for concern in the use of non-steroidal anti-inflammatory medications in the community--a population-based study.
Cause for concern in the use of non-steroidal anti-inflammatory medications in the community--a population-based study.
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DOI：
10.1186/1471-2296-12-70
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发表时间：
2011-07-07
影响因子：
2.9
通讯作者：
Hill CL
中科院分区：
文献类型：
--
作者：
Adams RJ;Appleton SL;Gill TK;Taylor AW;Wilson DH;Hill CL
非类固醇抗炎(NSAID)药物是报道的药物不良反应的常见原因。这项研究描述了非类固醇抗炎药(非小剂量阿司匹林除外)的使用情况，以及在典型人群样本中非类固醇抗炎药的使用与慢性病共存的相对禁忌症。分析了2004-2006年参加西北阿德莱德健康研究(NWAHS)第一次后续行动的3,206名成年人的数据，这是一项具有代表性的纵向人口研究。参与者将药物带到研究诊所就诊。临床评估包括测量血压、肾功能、血清胆固醇、血糖。问卷评估了人口统计学、生活方式风险因素、医生诊断的慢性病。数据按地区、年龄组、性别和在家庭中被选中的概率对人口普查措施进行加权，以提供具有代表性的人口估计。皮尔逊的卡方检验确定了比例上的显著差异。采用多元Logistic回归分析社会人口学特征与非甾体抗炎药使用之间的关系。在3175名参与者中，357名(11.2%)和16%的55岁年龄组报告使用了非特异性非类固醇抗炎药或COX-2抑制剂，而不是小剂量阿司匹林。在使用非甾体抗炎药的人群中，60.8%的人有高血压，30.8%的人有3级或更高的慢性肾脏疾病，17.2%的人有心血管疾病史，20.7%的人有15%的10年心血管疾病风险。高血压患者中非甾体抗炎药的使用率为16%，肾脏疾病的患病率为15.9%，心血管病史的患病率为20.0%。在服用利尿剂的人中，24.1%的人同时服用非类固醇抗炎药，而在服用胃食道反流药物的人中，24.7%的人服用非类固醇抗炎药。75岁的人比35-54岁的人更多地使用处方COX-2抑制剂，而不是其他非类固醇抗炎药(OR 3.7，95%CI 2.0，6.7)，高血压、心脏病和肾脏疾病的患者也更常使用。在发生重大药物相关不良事件的风险人群或患有与非甾体抗炎药使用相对禁忌症的重大慢性病的人群中，目前非甾体抗炎药的使用率很高。对心血管和肾脏疾病绝对风险的评估需要考虑非类固醇抗炎药等药物的使用。通过改进非类固醇抗炎药的使用，对慢性疾病负担产生重大影响的潜力是相当大的。
Non-steroidal anti-inflammatory (NSAID) medications are a common cause of reported adverse drug side-effects. This study describes the prevalence of non-steroidal anti-inflammatory (NSAID) use (other than low-dose aspirin) and the presence of co-existing relative contraindications to NSAID use and chronic conditions in a representative population sample. Data were analysed from 3,206 adults attending first follow-up of the North West Adelaide Health Study (NWAHS) in 2004 - 2006, a longitudinal representative population study. Medications were brought into study clinic visits by participants. Clinical assessment included measured blood pressure, kidney function, serum cholesterol, blood glucose. Questionnaires assessed demographics, lifestyle risk factors, physician-diagnosed chronic conditions. Data were weighted to census measures by region, age group, gender, and probability of selection in the household, to provide population representative estimates. Pearson's Chi-square tests determined significant differences in proportions. Multiple logistic regression was used to examine associations of socio-demographic characteristics with use of NSAIDs. Of 3,175 participants, 357 (11.2%), and 16% of those aged > 55 years, reported using either non-specific NSAIDs or COX-2 inhibitors, other than low-dose aspirin. Among people using NSAIDs, 60.8% had hypertension, 30.8% had Stage 3 or higher chronic kidney disease, 17.2% had a history of cardiovascular disease (CVD) and 20.7% had a > 15% 10-year CVD risk. The prevalence of NSAID use among people with hypertension was 16%, with kidney disease 15.9%, and a history of CVD 20.0%. Among people taking diuretics, 24.1% were also taking NSAIDs, and of those taking medications for gastro-esophageal reflux, 24.7% were on NSAIDs. Prescription-only COX-2 inhibitors, but not other NSAIDs, were used more by people > 75 years than by 35-54 year olds (OR 3.7, 95% CI 2.0, 6.7), and also were more commonly used by people with hypertension, cardiac and kidney disease. There is a high prevalence of current NSAID use among groups at-risk for significant drug-related adverse events or who have major chronic conditions that are relative contraindications to NSAID use. Assessment of absolute risks regarding cardiovascular and kidney disease need to take into account use of medications such as NSAIDs. The potential to make a substantial impact on chronic disease burden via improved use of NSAIDs is considerable.
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影响因子：
3.4
作者：
Cutts, C;LaCaze, A;Tett, S
通讯作者：
Tett, S
影响因子：
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作者：
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DOI：
10.1111/j.1467-842x.1998.tb01177.x
发表时间：
1998-04-01
影响因子：
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作者：
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通讯作者：
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2.3
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Reicin, A
影响因子：
7.2
作者：
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