Nonsteroidal antiinflammatory drug starter packs for chronic musculoskeletal pain.
OBJECTIVE
To determine whether prescribing a nonsteroidal antiinflammatory drug (NSAID) starter pack for chronic musculoskeletal pain expedites the process of finding an appropriate drug for a given patient.


METHODS
Prospective patient interviews.


METHODS
Veterans Affairs Medical Center.


METHODS
Sixty-four patients with chronic musculoskeletal pain were prescribed NSAID starter packs. Of those, 42% were interviewed and their data evaluated.


METHODS
Between March and June 2001, patients received starter packs containing 1-week supplies of the following NSAIDs: ibuprofen, salsalate, etodolac, naproxen, sulindac, and piroxicam. The patients took one drug each week, then returned to their providers to receive a prescription for the agent that was considered most effective and tolerable.


RESULTS
Patients assessed pain each day based on a numeric pain-rating scale. During telephone interviews, seven patients reported better pain control when they were able to select a drug from the starter pack than when they were prescribed a specific drug by their providers. Providers rated the starter pack as easy to use by patients and generally effective for finding the best NSAID for a particular patient. Drugs prescribed after completing the starter pack were salsalate 25.9%, piroxicam 22.2%, etodolac 14.8%, ibuprofen 14.8%, naproxen 11.1%, celecoxib 7.4%, and an opiate 3.7%.


CONCLUSIONS
The NSAID starter pack appears to be a successful method for quickly and easily finding an NSAID that is effective and tolerated.
Department of Pharmacy Practice, College of Pharmacy, University of South Carolina, Columbia 29208, USA.
John C
JC
Voris
Cynthia M
CM
Phillips
Cynthia T
CT
Voris
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D004349:Drug Packaging / Q000379:methods* / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000188:drug therapy* / Q000523:psychology; D010146:Pain / Q000188:drug therapy* / Q000523:psychology; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D000894:Anti-Inflammatory Agents, Non-Steroidal