Statistics and prescription database studies show that analgesics are widely utilized, but do not tell anything about either the factors behind analgesic use or how over-the-counter (OTC) analgesics are being used. We aimed to study the prevalence of frequent use of prescribed and OTC analgesics. We also investigated the background factors related to frequent analgesic use and assessed rationality of analgesic usage patterns. We addressed a postal survey to a random stratified population sample of 6500 Finnish people aged 15-74 years. The response rate was 71% (n=4542) after exclusion of unobtainable addressees (n=68). Individuals reporting analgesic use 'daily' or 'a few times a week' were categorized as frequent users. After adjusting for age and sex, the overall prevalence of daily analgesic use was 8.5%, and the prevalence of analgesic use a few times a week 13.6%. The adjusted prevalence of using exclusively prescribed analgesics daily or a few times a week was 8.7%, and that of utilizing purely OTC analgesics 8.8%. The overall prevalence of concomitant frequent use of both prescribed and OTC analgesics was 4.6%. Multinominal logistic regression analyses showed that frequent analgesic use was related especially to daily or continuous pain and high pain intensity. Low mood and not being employed also increased the probability for daily analgesic use. Frequent analgesic use seems to be common at population level. Concomitant use of both prescribed and OTC analgesics can be considered irrational, as it increases the risk of adverse events.

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Depending on the decision-maker's willingness-to-pay threshold, either sumatriptan 100 mg or eletriptan 40 mg is likely to be cost-effective.

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Chronic musculoskeletal pain is a highly persistent condition among community-dwelling older persons and it is related to poor health and mobility difficulties. In addition, the use of daily analgesic is low despite the continuous nature of chronic pain.

The results of published economic studies of triptans are conflicting and biased. There is a tendency to select clinical outcome measures that support the sponsor's product. This leads to concern about the possible poor applicability of these results in decision making.

physicians need to take a more active role in the process of recognising, assessing and controlling persistent pain in older people.

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