Analyse de la prescription des antalgiques de palier II en médecine générale. Observatoire de la médecine générale - 2007 à 2009

The objectives of this study, conducted by the French Society of General Medicine, were to analyze the level II analgesic prescription in general medicine practice over the period 2007-2009 using data collected by general practitioners participating to the General Medicine Observatory. Factors that may influence physicians' decision to prescribe level II analgesics (patient's age, concomitant diseases and treatments) were also evaluated. In addition, the impact on the level II analgesic prescription of a project of dextropropoxyphene containing-medicines withdrawal, adopted at the European level, was assessed. A total of 21,007 patients were prescribed level II analgesics in the course of 55,228 visits during which 167,617 diagnoses, including 62,623 diagnoses with pain component, were recorded. Level II analgesics were mainly prescribed in patients aged 40 years or older, presenting musculo-skeletal (low back pain, arthropathy-periarthropathy) and rheumatologic (arthritis) diagnoses, frequently characterized by chronic evolution. Although the project of dextropropoxyphene containing-medicines withdrawal led to a decrease in the number of prescriptions of the paracetamol/dextropropoxyphene combination (−12.6%), this combination remained the most frequently prescribed level II analgesic. Inversely, an increase in the number of prescriptions of paracetamol/codeine (+5.1%), paracetamol/tramadol (+4.6%) and in a lesser extent tramadol alone (+1.3%) and lamaline (+1.3%) was observed.