Pain therapy in patients with musculoskeletal disorders in outpatient setting: A cohort study

Abstract

Objectives: The aim was to determine the habits of physical medicine and rehabilitation specialists (PRM) in the prescription of analgesics and application of different physical modalities in outpatients, and to investigate if there are any differences with respect to doctors age. Methods: We performed a retrospective study of outpatients treated at the Clinic for Physical Medicine and Rehabilitation, Clinical Center Serbia, for 3 month period. The assessment was performed by patient reports analysis. We investigated the age of doctors, the diagnosis, whether pain intensity was measured using validated pain scale, if analgesics, physical modalities, or the combination were prescribed. We also examined the type of prescribed analgesics. Results: Out of 340 outpatients (192 males, 148 females, mean 45.2 ± 15.89 years) treated by 19 PRM specialists were included in the study. PRM specialists did not measured pain intensity by any valid scale in 296 patients (87.1%). NSAIDs where most used analgesic in 90 patients (26,5%). Opioids where used in only five patients (1.5%). Our results revealed that younger doctors prescribed more often analgesics than older (47.4 vs. 30.2%). Younger doctors also prescribe more often the combination of analgesics and different physical modalities (42.7 vs. 29.2%). Conclusions: We found that the most often prescribed are different physical modalities. The intensity of pain was measured by any validated pain scale in low percentage. Among transcribed analgesics, NSAIDs had the highest percentage, while the opioids were prescribed very little. Younger specialists prescribed analgesics more often as well the combination of analgesics and different physical modalities.

Keywords:

• analgesics
• physical modalities
• prescription
• habits

Public Interest Statement

This paper informs about the use of analgesics for the treatment of musculoskeletal pain and the most common types of which are transcribed. It suggests what type of analgesic is prescribed unjustifiably little. This paper highlights the differences in analgesic prescribing in relation to the economic situation of countries, compares treatment and thus points to the need to follow the latest trends of treatment for more efficient therapy of musculoskeletal diseases, and to better inform the patients themselves.

Competing Interests

The authors declare no competing interest.

Acknowledgment

We would like to thanks to Clinic for Physical Medicine and Rehabilitation, Clinical Center Serbia in Belgrade for using their material.

Additional information

Notes on contributors

Stefan Kostadinović

Authors key research activities are all activities from the field of clinical research with an emphasis on physical medicine and rehabilitation, cardiovascular pathology and clinical kinesitherapy as well.

For better treatment efficacy of musculoskeletal pain, especially in developing countries, is necessary intensive training of specialists as well as quality of analgesics prescriptions, to which its conclusions to this paper indicates. This work emphasizes the use of opioids in a lesser extent, and points to new, modern trends in the wider application of these analgesics.