Musculoskeletal Matters 6

MUSCULOSKELETAL MATTERS Keele University Bulletin 6 TRENDS IN GP PAIN MEDICATION PRESCRIBING Research has shown analgesics (painkillers) can be effective in treating musculoskeletal pain and up to 10% of all prescriptions issued in general practice are for analgesics. Analgesics can vary in strength (mild, moderate, strong), in the way they are taken (tablets, patches or topical creams), and some have anti-inflammatory actions whilst others do not. There are over 300 analgesics available to GPs to prescribe. To aid doctors in their choice, the Medicines and Health Products Regulatory Agency (MHRA) and NICE have produced guidance on the safe prescribing of analgesics for musculoskeletal pain. We assessed whether these guidelines have changed the way GPs prescribe analgesics. Cox-2 non-steroidal anti-inflammatories (NSAIDs) • I  n Dec 2004 – Feb 2005 MHRA advised GPs to stop using Cox-2 NSAIDs in patients with heart disease due to increased risks of cardiovascular events. • I  n North Staffordshire, this advice was associated with a significant decrease in the use of Cox-2 NSAIDs (Figure 1). Figure 1: Changes in North Staffordshire NSAID prescribing 2002-2009 These bulletins are designed to provide information for general practitioners, the primary care team, teachers, trainers and policy makers about musculoskeletal problems in practice.