An investigation into the prescribing of analgesics.

OBJECTIVE To investigate the prescribing of analgesic agents in a defined South African patient population. DESIGN Retrospective drug utilisation study. SETTING Prescribing behaviour of a sample of 50 dispensing doctors in Port Elizabeth. Data were obtained from a medical aid which used a formulary system. MAIN OUTCOME MEASURES Percentage of central nervous system drugs that analgesics comprised; proportion of patients using combination analgesics; cost of analgesics. RESULTS On average, 83.3% of all central nervous system drugs dispensed were analgesic agents. These agents represented 70.9% of the total cost of central nervous system drugs. A high percentage (82.2%) of the analgesic agents dispensed were combination or polycomponent analgesics. The combination analgesic tablet, consisting of paracetamol, meprobamate, caffeine and codeine phosphate, was the most frequently prescribed central nervous system drug. This product accounted on average for 40.4% of all analgesics dispensed. Nearly half (46.0%) of all the analgesics dispensed by the sample of doctors were available without a prescription. CONCLUSION The high prescribing rate of combination analgesic prescription was a cause for concern, given the dependence-producing potential of some of the ingredients, e.g. meprobamate. The prescribing and use of analgesics should be carefully monitored by further drug utilisation studies in light of the serious adverse effects, such as analgesic nephropathy, associated with the longterm use of these agents.