title: Prescription of nonsteroidal anti-inflammatory drugs and muscle relaxants for back pain in the United States.
abstract: METHODS
  Secondary analysis of the 2000 Medical Expenditure Panel Survey (MEPS). OBJECTIVE.: To examine national prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants among individuals with back pain in the United States.
  
  
  BACKGROUND
  There is a lack of information on national prescription patterns of NSAIDs and muscle relaxants among individuals with back pain in the United States.
  
  
  METHODS
  Traditional NSAIDs, cyclooxygenase-2-specific (COX-2) inhibitors, and muscle relaxants were investigated. Individuals with back pain were stratified by socio-demographic characteristics and geographic regions. For each medication category, overall prescribing frequency was compared across different strata and individual drug prescription was analyzed.
  
  
  RESULTS
  Traditional NSAIDs, COX-2 inhibitors, and muscle relaxants, respectively, accounted for 16.3%, 10%, and 18.5% of total prescriptions for back pain in 2000. Among individual drugs, ibuprofen and naproxen accounted for most of the prescriptions for traditional NSAIDs (60%), whereas two thirds of the prescriptions for muscle relaxants were attributable to cyclobenzaprine, carisoprodol, and methocarbamol. Prescription of COX-2 inhibitors or muscle relaxants demonstrated wide variations across different regions. Several individual characteristics including age, race, and educational level were associated with the prescription of some of the medications.
  
  
  CONCLUSIONS
  Neither traditional NSAIDs, nor COX-2 inhibitors, nor muscle relaxants dominated prescriptions for back pain. However, a small number of individual drugs were attributable to most of the prescriptions for traditional NSAIDs or muscle relaxants. The prescription of some of the medications demonstrated wide variations across different regions or different racial and educational groups. More studies are needed to understand the source of the variations and what constitutes optimal prescribing.
authors.affiliation: Center for Clinical Effectiveness, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA. luo00003@mc.duke.edu
authors.forename: Xuemei
authors.initials: X
authors.lastname: Luo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Hey
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001416:Back Pain / Q000188:drug therapy*; D003710:Demography; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009465:Neuromuscular Agents