%0 Journal Article
%T Nonsteroidal anti-inflammatory drugs and potential iatrogenic risks: an analysis using the French national health fund¡¯s database
%A L¨¦vy P
%A Fanello S
%A Pivette J
%A Parot-Schinkel E
%J Revue M¨¦dicale de l'Assurance Maladie
%D 2005
%I 
%X Aim: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed due to their numerous therapeutic actions and their use requires that well-codified prescription rules be carefully followed. The aim of this study was to see whether general practitioners and rheumatologists in the Pays de la Loire region took into account the inherent risks of NSAIDs when prescribing them. Method: The study material consisted in the information contained in the reimbursement database of the French national health insurance fund¡¯s general and agricultural schemes in the Pays de la Loire region. The information gathered was analyzed with respect to accepted medical guidelines. For the study, we enrolled all general practitioners and rheumatologists who had prescribed at least one NSAID during September and October 2001. Results: A large proportion of rheumatologists¡¯ (19.5 %) and general practitioners¡¯ (13.9 %) patients had been reimbursed for NSAIDs. Gastric protection was rarely associated with non-selective NSAIDs, notably in patients aged 65 years or older, in particular among general practitioners¡¯ patients. Monitoring of kidney function, when indicated, remained incomplete in patients aged 75 years or more. Prescribing physicians appeared to insufficiently consider the risks of hemorrhage when serotonin uptake inhibitors (SUI) were co-prescribed. Conclusion: This study showed that physicians do not sufficiently consider the risks inherent in the prescription of NSAIDs, particularly in older subjects (renal and gastrointestinal risks).
%K NSAID
%K side-effect
%K drug interaction
%K database
%K observational study.
%U http://www.ameli.fr/fileadmin/user_upload/documents/Anti-inflammatoires_non_steroidiens.pdf