Analgesic prescription habits in a population of patients with chronic rheumatic disease.

Abstract

The aim of this study was to record the analgesic prescription commonly performed by Portuguese Rheumatologists in patients with chronic Rheumatologic disease, using the guidelines provided by the World Health Organization for treatment of chronic pain as comparative.We randomly selected the clinical records of 203 patients with complete clinical record. We excluded patients with less than a year of follow-up, last consultations over a year ago, age under 16 years, patients with no rheumatologic diagnose, being the final sample of 94 patients. The items collected were gender, age, primary diagnosis, prescribed drugs (paracetamol, nonsteroidal anti-inflammatory steroids, glucocorticoids, tricyclic antidepressants, selective serotonin reuptake inhibitors - paroxetine and fluoxetine, anticonvulsants - gabapentin and pregabalin, colchicine and muscle relaxers with pain modulator effects of, weak and strong opioids), degree of pain (0-10).84.94% of patients were female and 15.06% male. The average age was 51.5 years, men's average was 54.0 years and women 51.1 years. Overall prescription of paracetamol was 23.4% and 8.5% for tramadol (always associated with paracetamol). In 17% of patients paracetamol was added successfully. The use of various antiinflammatory agents reached a prevalence of 80.9%. Other agents were also used either Glucocorticoids - Deflazacort and prednisolone - (36.2%), tricyclic antidepressants with expressed antalgic intention (6.4%).There was a discrepancy between the prescription and the current indications of WHO for the control of chronic pain. This discrepancy raises the possibility of failure of some pharmacological agents in this type of pain and/or lack of systematization of analgesic therapy. We recommend further studies to prove the hypothesis.