title: The association between pain intensity and the prescription of analgesics and non-steroidal anti-inflammatory drugs.
abstract: BACKGROUND
  It is not known whether general practitioners (GPs) prescribe analgesic medication according to intensity of pain or a hierarchical prescribing regimen.
  
  
  OBJECTIVE
  The aim of this study was to assess the association of strength of pain-relief medication prescribed by the GP with the strength of previous prescription and pain level.
  
  
  METHODS
  The PROG-RES study collected data on pain intensity in 428 patients aged ≥50 years with non-inflammatory musculoskeletal pain during a consultation with their GP. Prescriptions for analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) were identified on the day of the consultation and in the previous year and were classified as basic, moderate or strong analgesic or NSAID. Regression models were used to assess the association of strength of analgesia and prescription of a NSAID with the strength of previous prescription and the level of pain.
  
  
  RESULTS
  The majority of patients were not prescribed medication for their pain at the index consultation, but had such a prescription the previous year. There was an association between strength of analgesic and intensity of pain: more intense pain resulted in a stronger drug. This association was attenuated by adjustment for prescribed analgesia in the previous year. There was no association between intensity of pain and NSAID prescription, but previous NSAID prescription predicted another such prescription.
  
  
  CONCLUSIONS
  GPs do not always issue prescriptions for musculoskeletal pain. In cases where a prescription is issued, this is more strongly influenced by previous prescriptions than the patient's pain level. GPs adopt an individualized approach to the treatment of musculoskeletal pain in older adults.
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK. s.muller@cphc.keele.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Muller
authors.forename: J
authors.initials: J
authors.lastname: Bedson
authors.forename: C D
authors.initials: CD
authors.lastname: Mallen
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D011307:Drug Prescriptions; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D012720:Severity of Illness Index
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal