Arthritis sufferers misusing painkillers�

ISLAMABAD: Thousands of patients with severe arthritis are adding over-the-counter medication to prescribe drugs because GPs are limiting their doses amid safety fears.

The effectiveness of conventional painkillers is being hamstrung by concerns about their side effects, such as bleeding and other severe intestinal problems which can be fatal, according to researchers including Martin Green, chief executive of the charity Counsel and Care for the Elderly.

They report that GPs are not always prescribing to appropriate levels, meaning the drugs are not controlling pain as they should, and that doctors seem reluctant to use a new generation of drugs which have fewer side effects. Patients, therefore, are often turning to other pain-relieving drugs and creams instead.

Work by Mr Green and Brian Crichton, a GP and GP trainer in the West Midlands, suggests that a quarter of patients take over-the-counter medications as well as their prescriptions, and a quarter of doctors order low doses for drugs they prescribe, hoping they can control pain without side effects.

The pair report the findings from an electronic poll of 2,000 doctors and questionnaires returned by more than 3,100 patients with osteoarthritis in the journal Current Medical Research and Opinions. The research was funded by the drug company Merck Sharpe and Dohme.

It is thought that 2,000 people a year might die from complications linked to conventional treatments, still small compared with the millions suffering from osteoarthritis - many of whom are not on prescription drugs at all.

The research suggests patients are four times more likely to be dissatisfied with the poor pain relief caused by the drugs than by side effects such as stomach upsets.

The government's national institute for clinical excellence, which monitors the cost-effectiveness of treatments, last year endorsed the new generation of drugs only in those patients who might be at high risk of developing stomach side effects.

These included people over 65, those with gastrointestinal problems, and those already taking other medicines that could cause ulcers. The drugs themselves cost more money, but their supporters argue they more than make up for that by preventing return visits to GPs, hospital treatment and the need for other drugs to counter side effects.

Dr Crichton said: "If you are on a prescription painkiller and it is not working for you don't add another painkiller you have bought yourself. Always ask the advice of your doctor or local pharmacist."