Variability in prescribing for musculoskeletal pain in Finnish primary health care.
OBJECTIVE
To assess primary care physicians' prescribing patterns for musculoskeletal pain in different diagnostic categories.


METHODS
The data were collected in 25 randomly selected health centres, in which a total of 28 physicians took part in the four-week study. Physicians recorded all the medicines they prescribed for patients visiting due to pain. Visits resulting in a diagnosis of musculoskeletal disease or injury were included in this study.


RESULTS
Analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs), were prescribed for 61% of the patients. NSAIDs were prescribed for 46%, topical analgesics for 15% and opioids for 4% of the patients. In general, ibuprofen was the most frequently prescribed drug but back and neck pains were most commonly treated with naproxen. No difference between patients' genders was observed in analgesic prescriptions. Prescribing was associated with patient's age, physician's view on priority of visit, diagnosis and intensity of pain. There was a large variation in prescribing patterns between individual physicians and between different areas of the country.


CONCLUSIONS
NSAIDs are the prevailing treatment for musculoskeletal pain in Finnish primary health care. Different drugs are favoured according to the diagnosis. The large variability in prescribing patterns cannot be explained solely by the characteristics of pain or patients.
Mäntyselkä
P
P
Department of Public Health and General Practice, University of Kuopio, P.O. Box 1627, 70211 Kuopio, Finland.
Ahonen
R
R
Kumpusalo
E
E
Takala
J
J
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions; D004363:Drug Utilization; D005260:Female; D005387:Finland / Q000453:epidemiology; D005843:Geography; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D011320:Primary Health Care
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009125:Muscle Relaxants, Central