Criteria for selecting and using non-steroidal anti-inflammatory drugs in primary health care.

BACKGROUND Numerous non-steroidal anti-inflammatory drugs (NSAIDs) are commercially available in Spain. This makes proper selection and use of these drugs difficult for GPs. OBJECTIVE To find out the criteria which GPs use to choose among the drugs in this group and to evaluate other criteria related to the clinical management of NSAIDs. METHOD A survey questionnaire was distributed among all the GPs of the reformed network in the health area of Tarragona (Spain). RESULTS The doctors questioned chose a limited number of NSAIDs. Major preferences were diclofenac and piroxicam. The main criteria for selection were: efficacy and safety of the drug; previous and/or current gastrointestinal pathology of the patient; the difference between acute and chronic use; and the type of inflammatory process. There were a large number of combinations of routes of administration. The histamine H2 antagonists were the prophylactic drugs which were used most for gastropathy. CONCLUSION Sometimes the main criteria for choosing between the drugs in this study do not reflect the drugs that are used in clinical practice. Some of the criteria used by GPs for selecting and using NSAIDs should be reviewed.