Publication:

Analgesic prescribing trends in musculoskeletal disorders

Background Musculoskeletal disorders like osteoarthritis, rheumatoid arthritis, bursitis, backache, tendinitis, cervical spondylitis etc. are very commonly encountered in orthopaedic practice and are generally treated with various analgesic drugs. There are number of non-steroidal anti-inflammatory drugs (NSAIDs), opiod analgesics and also fixed dose combination (FDC) of analgesics available for the treatment of such disorders with some advantages and disadvantages of these drugs. Since few studies are there on utilization of analgesic drugs in the orthopaedic practice, this study was undertaken to determine the current prescribing trends for these disorders.

Methods It was record based observational study carried out at NKP salve institute of medical sciences, Nagpur. A total of 200 prescriptions of patients reported to orthopaedic outpatient department, with presenting complaints of musculoskeletal disorder and rheumatological conditions like osteoarthritis, rheumatoid arthritis, bursitis, backache, tendinitis, cervical spondylitis etc. were noted for the various analgesic drugs prescribed for these disorders.

Results The common age groups encountered for musculoskeletal disorders were between 41-50 years (26%) and 31-40 years (20%) followed by other age groups. The common conditions for which patient attended orthopaedic outpatient department were low backpain in 42 (21%) and osteoarthritis in 41(20.5%) patients followed by others. Aceclofenac and diclofenac were the most commonly prescribed analgesics in 25 (12.5%) and18 (9%) patients followed by other analgesics. Fixed dose combinations of NSAIDS with other NSAIDS or opoid analgesic were also commonly prescribed. Diclofenac + Paracetamol and Tramadol + Paracetamol were most commonly prescribed combinations in 30 (15%) and 19 (9.5%) patients respectively.

Conclusions As monotherapy aceclofenac and diclofenac were the most commonly prescribed NSAIDS for various musculoskeletal disorders. Also, fixed dose combinations of NSAIDS with other NSAIDS or opoid analgesic were also commonly prescribed. Diclofenac + Paracetamol and Tramadol + Paracetamol were the most commonly prescribed FDCs in our study.