Prescription of analgesics in general medical practice

The aim of this study was to examine the frequency of prescription of analgesic drugs by General Practitioners in Austria, the reasons for which they are prescribed, as well as relevant organizational details. A questionnaire was designed to prospectively collect data from 14 participating General Practitioners over a period of at least 20 days each. The type of analgesic drugs prescribed during direct (doctor) or indirect (receptionist) consultations was recorded, coded according to the ATC classification and separated into first and repeat consultations. Furthermore, the diagnostic terms and the individual intensity of pain perception by the patients were noted. During 7248 consultations recorded, 1083 prescriptions of analgesics were issued. The majority of first prescriptions are issued during direct consultations, whereas a large number of repeat prescriptions are prepared for the doctor's supervision by the receptionists via indirect consultations. Almost half of the patients receive repeat prescriptions. In both, direct and indirect consultations with patients, approximately every 7th contact results in the prescription of an analgesic drug. The antirheumatic drug group is the most frequently prescribed group of painkillers whereas opioids are rarely prescribed. Selection of drugs is not clearly related to the degree of pain experienced by individual patients. Problems of the musculo-skeletal system rank first among the classifications leading to prescription of an analgesic. Pain needs quick and efficient therapy. Prescriptions of analgesics in General Practice ought to be issued in such a way as to serve this large group of patients without, however, taking extensive risks: repeat and first prescriptions issued during indirect consultations have to be precisely recorded and need the doctor's personal supervision.