Survey on appropriateness of use of nimesulide in nine European countries

Abstract

Background: Appropriateness of use is a key factor in safeguarding patient's health as well as a product's therapeutic properties. This paper presents the results of a survey conducted in nine European countries to verify the appropriateness of use of nimesulide in patients with inflammatory pain.

Methods: Computer-aided telephone interviews were administered to 1,277 nimesulide-prescribing general practitioners in Bulgaria, Czech Republic, Greece, Hungary, Italy, Poland, Portugal, Romania, and Slovakia, covering an estimated 31,719 patients. The interview questionnaire collected information on nimesulide prescriptions with respect to daily dose, treatment duration, and indication.

Results: In the majority of cases, prescriptions of nimesulide did not exceed the recommended daily dose of 200 mg (given as 100 mg twice a day), with a range from 161 mg (Greece) to 190 mg (Slovakia). An adherence to the 15-day treatment limit was observed in over 90% of cases. The average number of treatment days was always less than 15, with a range from 5.4 (Italy) to 13.6 (Czech Republic). Nimesulide was primarily used for the treatment of acute pain and short-term painful episodes in chronic conditions. The presence of gastrointestinal diseases/ulcers was the most frequent reason for not prescribing nimesulide.

Conclusion: The results of this survey demonstrate that nimesulide is generally prescribed in compliance with the information reported in the summary of product characteristics (SmPC) with regard to daily dose and treatment duration, and suggest that it is mainly used for the management of episodes of acute pain in patients with a chronic disorder. These findings indicate the appropriateness of use of nimesulide in the European countries considered in this survey.

Keywords: European Medicine Agency; NSAID; appropriateness of use; computer-aided telephone interviews; non-steroidal anti-inflammatory drug.

Figure 1

Pattern of use emerging from the question “For which disease was this patient prescribed nimesulide?” presented by the percentage of patients by country and by disease group. Note: Total number of estimated nimesulide-treated patients: Italy, 7,457; Portugal, 1,203; Bulgaria, 4,107; Poland, 5,380; Czech Republic, 3,930; Romania, 3,210; Slovakia, 2,034; Hungary, 3,156; Greece, 1,242. Abbreviation: Czech Rep, Czech Republic.

Figure 2

Pattern of use emerging from the question “And which posology did you prescribe to this patient?” presented by the percentage of patients by country. Note: Total number of estimated nimesulide-treated patients: Italy, 7,457; Portugal, 1,203; Bulgaria, 4,107; Poland, 5,380; Czech Republic, 3,930; Romania, 3,210; Slovakia, 2,034; Hungary, 3,156; Greece, 1,242. Abbreviation: Czech Rep, Czech Republic.

Figure 3

Pattern of use emerging from the question “What was the duration of therapy prescribed?” presented by the percentage of patients and by average days prescribed. Note: Total number of estimated nimesulide-treated patients: Italy, 7,457; Portugal, 1,203; Bulgaria, 4,107; Poland, 5,380; Czech Republic, 3,930; Romania, 3,210; Slovakia, 2,034; Hungary, 3,156; Greece, 1,242. Abbreviation: Czech Rep, Czech Republic.