Kaufman David W, Kelly Judith P, Battista Deena R, Malone Mary Kathryn, Weinstein Rachel B, Shiffman Saul
Slone Epidemiology Center at Boston University, Boston, MA, USA.
Pinney Associates, Pittsburgh, PA, USA.
Pharmacoepidemiol Drug Saf. 2018 Mar;27(3):322-331. doi: 10.1002/pds.4391. Epub 2018 Jan 26.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective and very commonly used, but also have side effects. We determined prevalence of NSAID dosing exceeding the daily limit (EDL) and identified related user characteristics and dosing patterns among current ibuprofen users.
Online 1-week diary study of 1326 ibuprofen users. NSAIDs were identified by list-based prompting; respondents were not required to know their medications were NSAIDs. Details of hourly use were recorded by respondents daily. Deviations from dosing directions were programmatically determined afterwards. An exit survey obtained information on demographics, medical history, physical and mental health status, attitudes regarding label reading and dosing behavior, and knowledge of product label instructions.
Most diary users (90%) took over-the-counter ibuprofen during the week; 37% also took non-ibuprofen NSAIDs. Most did not recognize all products taken as NSAIDs. EDL occurred among 11% of users for ibuprofen, 4% of users for other NSAIDs, and on 9.1% of NSAID usage days. EDL was associated with deviations from detailed dosing directions, particularly exceeding the 1-time dose, which occurred more often with medications with 1-pill doses. Personal characteristics associated with EDL included male sex, ongoing pain, poor physical function, daily smoking, having the attitudes of "choosing my own dose" and not starting with the lowest dose, and poor knowledge of the recommended 1-time and 24-hour doses.
The prevalence of EDL among NSAID users is nontrivial, and it is associated with potentially modifiable factors. Educating consumers about NSAIDs and their dosing directions could reduce excess dosing.
非甾体抗炎药（NSAIDs）疗效显著且使用广泛，但也存在副作用。我们确定了布洛芬使用者中超过每日限量（EDL）的NSAIDs给药情况，并识别了相关的使用者特征和给药模式。
对1326名布洛芬使用者进行为期1周的在线日记研究。通过基于列表的提示来识别NSAIDs；受访者无需知道他们所服用的药物为NSAIDs。受访者每天记录每小时的用药细节。之后通过程序确定与给药说明的偏差。一项退出调查获取了有关人口统计学、病史、身心健康状况、对标签阅读和给药行为的态度以及对产品标签说明的了解等信息。
大多数日记使用者（90%）在一周内服用了非处方布洛芬；37%的人还服用了非布洛芬类NSAIDs。大多数人并未意识到所有服用的产品均为NSAIDs。11%的布洛芬使用者、4%的其他NSAIDs使用者以及9.1%的NSAIDs使用日出现了EDL。EDL与详细给药说明的偏差相关，尤其是超过单次剂量，这种情况在单粒剂量的药物中更为常见。与EDL相关的个人特征包括男性、持续疼痛、身体功能不佳、每日吸烟、有“自行选择剂量”的态度且未从最低剂量开始服用，以及对推荐的单次和24小时剂量了解不足。
NSAIDs使用者中EDL的发生率不容小觑，且与一些可能可改变的因素相关。对消费者进行有关NSAIDs及其给药说明的教育可减少过量用药情况。
