Is it ethical to prescribe paracetamol for acute low back pain and osteoarthritis?
Access status:
Open Access
Type
ArticleAuthor/s
Day, ROCohen, M
Coleshill, MJ
Ghinea, N
Lipworth, W
Maher, CG
Latimer, J
Lin, CWC
McLachlan, AJ
Abstract
Despite accumulating evidence indicating that paracetamol is no more efficacious than placebo for acute uncomplicated low back pain and symptomatic osteoarthritis, it is still prescribed for these conditions. This is likely due to perceived clinical improvement in pain observed ...
See moreDespite accumulating evidence indicating that paracetamol is no more efficacious than placebo for acute uncomplicated low back pain and symptomatic osteoarthritis, it is still prescribed for these conditions. This is likely due to perceived clinical improvement in pain observed when the medicine is taken and the known harms associated with pharmacological alternatives. The benefits observed in the majority of patients are, however, likely to be placebo effects. This scenario poses an ethical dilemma between respecting patient autonomy by providing complete information while also promoting clinical benefit (beneficence). This article discusses this situation and considers a framework in which paracetamol might continue to be prescribed for these conditions in an ethical manner, namely through discussing the evidence and the benefit that some patients experience from it.
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See moreDespite accumulating evidence indicating that paracetamol is no more efficacious than placebo for acute uncomplicated low back pain and symptomatic osteoarthritis, it is still prescribed for these conditions. This is likely due to perceived clinical improvement in pain observed when the medicine is taken and the known harms associated with pharmacological alternatives. The benefits observed in the majority of patients are, however, likely to be placebo effects. This scenario poses an ethical dilemma between respecting patient autonomy by providing complete information while also promoting clinical benefit (beneficence). This article discusses this situation and considers a framework in which paracetamol might continue to be prescribed for these conditions in an ethical manner, namely through discussing the evidence and the benefit that some patients experience from it.
See less
Date
2019-01-01Publisher
ElsevierLicence
© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Citation
Day RO, Cohen M, Coleshill MJ, Ghinea N, Lipworth W, Maher CG, Latimer J, Lin CWC, McLachlan AJ. 2019. Is it ethical to prescribe paracetamol for low back pain and osteoarthritis? Lancet Rheumatology. Vol 1 e140. https://doi.org/10.1016/S2665-9913(19)30041-4Share