Take the drugs according to the labeled dosage instructions or as instructed by your doctor or pharmacist. Do not take more than the recommended dose as this will increase the risk of serious side effects. Painkillers should not be shared with anyone else, as different people may experience pain with different cause and severity. Avoid drinking alcohol if you are taking analgesics as it may increase the risk and severity of side effects of the medicines.
Maintain a healthy weight as extra pound puts additional strain on back muscles and joints, which may make back pain and knee pain worse. Keep doing gentle exercises, such as walking and swimming to avoid inactivity leading to cycle of increased pain and loss of function. Breathe slowly and deeply when you are in pain which can keep you relaxed and prevent muscle tension or anxiety from worsening the pain.
Try your best to describe the nature and severity of pain to your doctor, since pain is always personal and is difficult to define and treat. Communicate with your doctor for the best treatment option. Your doctor will prescribe the most appropriate drugs for you after considering your condition and your response to the drugs. Inform your doctor of the medicines you are taking and your medical history, as other drugs may interact with analgesics and some diseases may warrant special precautionary measures.
Inform your doctor that you are pregnant or breast feeding as some of the oral analgesics should not be taken by women during that period. Seek medical advice immediately if you experience any symptoms or side effects suspected to be related to analgesics. Your doctor may review your type and dosage of medication. Have regular medical follow-ups as advised by your doctor if you need to use analgesics on a long-term basis. They are very effective, but they can sometimes have serious side effects.
There is also a risk of addiction. Because of the risks, you must use them only under a doctor's supervision. There are many things you can do to help ease pain. Pain relievers are just one part of a pain treatment plan. The information on this site should not be used as a substitute for professional medical care or advice.
Contact a health care provider if you have questions about your health. This study applied a retrospective observational study by using a database of the Chinese Pharmaceutical Association. The final dataset covers 30 provinces and municipalities in China, with a total of public hospitals with complete procurement records of analgesics from January to December Procurement cost and dosage utilization were analyzed through descriptive trend statistics.
From the procurement cost data, analgesics mainly consisted of opioids and non-steroidal anti-inflammatory drugs NSAIDs , and the annual cost of both types of drugs increased yearly. From to , the annual cost of opioids nearly doubled, while the annual cost of NSAIDs doubled.
The annual clinical drug dosage of opioids has more than doubled. The top three opioid drugs were dezocine injection, remifentanil injection, and sufentanil injection solution.
In China, analgesics utilization increased rapidly at public hospitals from to Within the two types of analgesics, the main analgesics utilization is also highly concentrated, with some highly risky analgesics.
The rational guideline for the utilization of analgesics needs to be established with the support of real-world evidence. Analgesics are widely used in pain management. There is a wide range of analgesics, which span across many drug classifications. At present, the analgesics used in the clinical setting can be generally divided into five categories: opioids, non-steroidal anti-inflammatory drugs NSAIDs , non-opioid central nervous analgesia, local anesthesia, and others [ 1 ].
Appropriate use of analgesia can not only alleviate the sufferings of the patients, but also benefit the recovery of the diseases, and has significant social and economic benefits [ 2 , 3 ]. However, due to a lack of clinical guidelines that details the safe and effective use of analgesics in pain management, there are many cases of unreasonable situations in the clinical use of analgesics around the world [ 4 ].
In recent years, the Chinese government has been committed to promoting the rational use of drugs in clinical practice and issued a series of policies, including reducing drug proportion in public hospitals year by year, reforming of health insurance payment from single to compound payment, accelerating the implementation of clinical pathway method, piloting and promoting the use of diagnosis-related groups DRGs , promoting the rational clinical use of drugs, and so on [ 7 , 8 ].
In the 13th Five Year Plan, the establishment of a comprehensive evaluation system for clinical drugs has been proposed to be accelerated, and analgesics are one of the key tasks [ 9 ].
The National Health Commission NHC has entrusted various departments with organizing and carrying out a comprehensive evaluation of clinical drug use in various fields and explore the evaluation results as an essential reference for centralized drug purchase and formulation of clinical drug use guidelines [ 10 , 11 ].
One of the conventional approaches was to analyze the utilization or reimbursement data for drug utility evaluation. However, most of the current research on analgesics utilization in China was only based on data from a single hospital or a single city or a province level, which with a narrow time interval. Besides, most of them had no comparative study of multiple types of analgesics. Li et al. Wang [ 13 ], Zhi et al. Studies on analgesics consumption by health care institutions at the national level with conducting a comparative study of multiple types of analgesics and a long-time interval are still rare in China.
Thus, this research aimed to evaluate analgesic utilization in public hospitals from to by analyzing the procurement data of hospitals in China.
This study will help to generate evidence for policymakers to design health policy interventions to promote rational use of analgesics at national level. In addition, it will provide evidence for global cooperation on optimizing analgesics. This study applied a retrospective observational research design by investigating the dataset extracted from an existing database. The final dataset of this study covered 30 provinces and public hospitals in China from 1st January to 31st December We collected complete procurement records of analgesics, including drug name, drug administration route, dosage form, procurement amount, and procurement quantity.
The exclusion criteria included: 1 no active pharmaceutical ingredients APIs ; 2 excluding external dosage forms nasal drops, eye drops, syrups, and gargles except patches.
All the drugs from the database follow the ATC classification. The classification of analgesics in this study referred to the generic drug names according to the "Consultations of Experts on Pain Management after Surgery in Adults " and the "Consensus of Experts in Pain Management in General Surgery " [ 16 , 17 ].
The generic name of the drug is used to identify the analgesic. The types of analgesics included:. Opioids: morphine, oxycodone, hydromorphone, sufentanil, hydrocodone, fentanyl, butorphino, dezocine, pethidine, pentazocine, nalbuphine, buprenorphine, codeine, dihydrocodeine.
Non-steroidal anti-inflammatory drugs NSAIDs : ibuprofen, diclofenac, meloxicam, celecoxib, lornoxicam, acetaminophen. Firstly, this study retrospectively analyzed the clinical use of analgesics in China in terms of procurement cost. The cost data were collected from the China Pharmaceutical Economic Information Network database CMEI , including drug name, drug administration route, dosage form, procurement amount, and procurement quantity.
According to the classification of analgesics, the total procurement cost of 6 years, and the changes in annual procurement cost were measured. In addition to procurement cost, this study assessed dosage utilization. In this research, we used total DDD to show the yearly quantity of one type analgesics. Total DDD of each type of analgesic means the sum of drug use in that category in 1 year. DDD refers to the average daily dose of an adult drug used for primary treatment purposes.
In this study, the Drug Dosage Index DDI uses the clinical analgesics dosage in as the base value and uses the fixed base ratio to represent the annual dosage index of the analgesic. Then further analyzes the changes in the clinical use of the analgesic. For data analysis, firstly, this study used descriptive statistics to analyze the characteristics of the overall procurement cost and annual cost share of analgesics.
Secondly, this study analyzed the procurement cost and annual cost share of the main analgesic types individually. Thirdly, this study analyzed the clinical use of analgesics quantitatively through DDD. The key analgesics in the main categories were further screened by DDD value, and the DDI was analyzed to demonstrate the changes in clinical use of analgesics. As shown in Table 1 , regarding the overall procurement cost, opioids and NSAIDs were the two main types of analgesics procured by the sample hospitals.
The total procurement cost of analgesics in sample hospitals reached billion CNY in 6 years. The total cost of opioids, which is the highest, was 17, Among the rest, the cost of local anesthetics was 3. The total cost and proportion of opioids and NSAIDs over the past 6 years far exceeded that of other types. The sum of the total cost of the two types of analgesics reached From to , the annual cost of opioids and NSAIDs has increased yearly, and the increase in opioids is even higher, as shown in Fig.
The annual cost of opioids increased from million CNY in to million CNY in , which was a nearly doubled increase. The proportion of opioids increased from As shown in Fig. Followed by remifentanil injection, the total cost was The third one was sufentanil injection, with a total cost of Oxycodone oral agent ranked fourth, with a total cost of 8.
Among them, the annual cost of dezocine injection increased the most, rising from million CNY in to million CNY in , which was an increase of more than two times.
The annual cost of the other three drugs also increased with a relatively flat during the 6 years. The cost proportion of remifentanil injection and sufentanil injection showed a slight downward trend. The cost proportion of oxycodone oral solution remained stable. As shown in Table 2 , the top 10 analgesics of NSAIDs included: flurbiprofen injection, parecoxib injection, celecoxib oral solution, propacetamol injection, flurbiprofen patches, ketorolac injection, ibuprofen oral, diclofenac oral, meloxicam oral, and lornoxicam injection.
Among them, flurbiprofen injection was the most, with a total cost of The second was parecoxib injection, with a total cost of Celecoxib oral preparations ranked third, with a total cost of Among them, the annual cost of flurbiprofen injection kept increasing yearly, and the growth rate was the largest.
From to , the annual cost has increased from million CNY to million CNY, an increase of more than doubled. The annual cost of the other four drugs also increased to a certain extent, with a flat trend. The proportion of flurbiprofen injection remained the highest, up to Flurbiprofen injections and flurbiprofen patches accounted for an overall upward trend in the annual cost.
Parecoxib injections and celecoxib oral administrations showed a general downward trend. Propacetamol injections from to rose slightly and gradually declined in the next few years. The total dosage for 6 years reached 7. The total dosage of opioids used for 6 years was Health Topics. Health Tools. Reviewed: November 25, Medically Reviewed. An analgesic is a medicine that relieves pain.
These drugs can be sold as an over-the-counter OTC or prescription drug. There are different types of analgesics, including: Opioids narcotics , such as Avinza, Kadian, or MS Contin morphine , Oxycontin oxycodone , Dolophine or Methadose methadone , Dilaudid hydromorphone , codeine , Demerol meperidine , Duragesic or Actiq fentanyl , and others Tylenol acetaminophen Combination medicines that contain Tylenol and an opioid Non-steroidal anti-inflammatory drugs NSAIDs , such as Advil ibuprofen , Aleve naproxen , Celebrex celecoxib , and others Aspirin acetylsalicylic acid , which is sometimes considered an NSAID The medicines are commonly used to treat pain due to arthritis, surgery, injury, toothache, headache, menstrual cramps , sore muscles , or other causes.
How Does an Analgesic Work?
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