Analgesic Equivalent Days: A Novel Approach to Assess Chronic Analgesic Use in the Population

Michael S Ortiz

doi:10.2174/1874220302007010007

Abstract

Introduction: There is no simple method to compare the use of multiple analgesic products in mild to moderate pain. The aim of this study is to validate a new tool to assess analgesic use. Methods: A measure of Analgesic Equivalent Days (AEDs) was developed using Defined Daily Doses (DDD) and the total mg of each analgesic over a 12 month period. Comparisons were made using analgesic class and all analgesics combined. Results: In a group of newly initiated patients with Osteoarthritis, AEDs values indicated that patients received around 70% of AEDs from paracetamol, 20% from NSAIDs and 10% from opioids. AEDs were similar between the two paracetamol formulations. However, one group took 8 more AEDs of NSAIDs, while the other group took 7 more AEDs of opioids. Conclusion: Even though the total AED scores, there was no significant difference in total analgesic use between the two formulations, differences were found among the analgesic classes. The AED methodology was sufficiently sensitive to demonstrate that one group of patients climbed higher up the analgesic ladder than the other group. AEDs are easy to calculate and seem to produce valid outcomes from both a statistical and a clinically meaningful perspective.

Highlights

There is no simple method to compare the use of multiple analgesic products in mild to moderate pain
OA patients had an average age of 69 years, 62.8% were female and patients took an average of 1.8 analgesic classes over the year
NSAIDs and Cyclooxygenase-2 Inhibitors (COX-2I) accounted for 20% of Analgesic Equivalent Days (AEDs), while opiates and codeine combination analgesics accounted for 10% of AEDs

Summary

Introduction

There is no simple method to compare the use of multiple analgesic products in mild to moderate pain. It is difficult to adequately assess analgesic use over time because patients take multiple analgesic products in various strengths and pack sizes. These analgesics can be taken chronically or acutely and for different indications, as well as for differing durations of time. There are oral Morphine Equivalent Daily Doses [2, 3], there is no method to combine and compare multiple analgesic products in mild to moderate pain. The Australian prescription claims database has been used to assess medication use in defined patient populations [4 - 8].

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Conclusion