A Survey of Pain Complaints and Treatment by General Practitioners in the Spanish Public Health Organization

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Abstract
The therapeutic habits of general practitioners are an important clue when drug therapy is considered, because they are treating the most frequent complaints. When pain problems are considered, it would be valuable to determine the characteristics of the pain consultations and their therapeutic attempts to solve these complaints. The present study was designed to elucidate the characteristics of pain diagnoses and treatment approaches at primary-care level in Spain. A total of 299 patients were evaluated, considering pain location, diagnostic syndrome, previous therapies, and treatments selected by the 13 participating physicians. Limb and back pain were the most frequent pain complaints. A third of the patients had received previous treatment and 36% were self-medicating, mainly with aspirin or paracetamol. Physicians prescribed diclofenac at full doses, but aspirin and paracetamol were used at subtherapeutic dosages. The study showed that (a) rheumatic pain was the most frequent at primary-care level, (b) a high level of self-medication was determined, therefore recommending a careful drug history, and (c) misconceptions about analgesic drugs may partially explain the therapeutic failure in some patients. Educational programs in rheumatic pain and analgesic therapy for general practitioners are strongly recommended.

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