Pure analgesics in a rheumatological outpatient clinic

Objective: Pure analgesics are only rarely used by Italian clinicians and this holds true also for rheumatologists. This work is concerned with an evaluation of the use of analgesics in a rheumatological outpatient clinic during the period 1989-1999. Methods: The records of 1705 patients consecutively seen at the clinic were downloaded on a specifically built website. Results: 4469 visits were considered. In 260 of them (5.8%), analgesics were prescribed to 234 (13.7%) patients. The number of patients with a prescription of analgesics steadily increased during the years 1989-1999. The diagnoses in patients assuming analgesics were: osteoarthritis (47.1%), inflammatory arthritis (24.2%), soft tissue rheumatisms (13.7%), nonspecific arthralgia/myalgia (7.5%), and connective tissue diseases (2.6%). Peripheral analgesics were used in 188 (82.5%) patients and central analgesics were used in the remaining 40 patients (17.5%). Analgesic drugs were used mainly in degenerative joint conditions. The indications for analgesics in the 55 patients with inflammatory arthrits were: (a) partial or total remission of arthritis; for this reason non-steroidal anti-inflammatory drugs were no longer required in 18 patients; (b) to increase the analgesic effect of NSAIDs in 23 patients; (c) contraindications to NSAIDs in 14 patients (renal failure in 2 patients, gastritis in 10, allergy and bleeding in the remaining two). Conclusions: About 14% of our outpatients were treated with analgesics with an increasing trend in the examined period. The main indications for analgesics are degenerative conditions but they can be used also in selected patients with arthritis.