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Nonsteroidal Antiinflammatory Drug Starter Packs for Chronic Musculoskeletal Pain
Author(s) -
Voris John C.,
Phillips Cynthia M.,
Voris Cynthia T.
Publication year - 2002
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.22.11.836.33631
Subject(s) - medicine , piroxicam , etodolac , naproxen , ibuprofen , starter , drug , medical prescription , osteoarthritis , visual analogue scale , anesthesia , pharmacology , alternative medicine , pathology , automotive engineering , engineering
Study Objective. To determine whether prescribing a nonsteroidal antiinflammatory drug (NSAID) starter pack for chronic musculoskeletal pain expedites the process of finding an appropriate drug for a given patient. Design. Prospective patient interviews. Setting. Veterans Affairs Medical Center. Patients. Sixty‐four patients with chronic musculoskeletal pain were prescribed NSAID starter packs. Of those, 42% were interviewed and their data evaluated. Intervention. Between March and June 2001, patients received starter packs containing 1‐week supplies of the following NSAIDs: ibuprofen, salsalate, etodolac, naproxen, sulindac, and piroxicam. The patients took one drug each week, then returned to their providers to receive a prescription for the agent that was considered most effective and tolerable. Measurements and Main Results. Patients assessed pain each day based on a numeric pain‐rating scale. During telephone interviews, seven patients reported better pain control when they were able to select a drug from the starter pack than when they were prescribed a specific drug by their providers. Providers rated the starter pack as easy to use by patients and generally effective for finding the best NSAID for a particular patient. Drugs prescribed after completing the starter pack were salsalate 25.9%, piroxicam 22.2%, etodolac 14.8%, ibuprofen 14.8%, naproxen 11.1%, celecoxib 7.4%, and an opiate 3.7%. Conclusion. The NSAID starter pack appears to be a successful method for quickly and easily finding an NSAID that is effective and tolerated.