The new-look Australian Journal of Pharmacy heralds a interesting direction in medical marketing and related advertising.
The front cover and inside two pages tell us that Panadol Osteo is “Australia’s No 1 pain reliever brand for osteoarthritis”.
Pharmacists insist on “evidence” when discussions emerge on other options for arthritic pain, and accordingly, may I supply some?

The British Medical Journal in February this year published a study with an interesting conclusion and I quote:

“Paracetamol is ineffective in the treatment of low back pain and provides minimal short term relief for people with osteoarthritis.”

Perhaps I’m a bit cynical, but this research seems to blunt the claims on the front cover of the latest AJP.

Furthermore, may I quote Arthritis Australia and the Australian Rheumatology Association:

“….concerns over (paracetamol) toxicity have been compounded by studies of paracetamol that suggest models efficacy in the relief of pain and to the extent that it is no longer recommended as first line medication management for the relief of osteoarthritis pain.”

A few pages into the current AJP, the old chestnut of homeopathic medicines is again raised, because of perceived (and it seems, incorrect) lack of evidence.

Or is the latter a further opportunity to fall into line with the RACGP and others, so that we lose our identity and relevance within primary care?

How about some consistency?

Is the evidence published in the BMJ incorrect?
Is their research flawed?
Or does money speak all languages in Australia?
Are we rejecting the concerns of Arthritis Australia and Australian Rheumatologists to gain advertising revenue and potentially mislead our patients?

After all, paracetamol doesn’t work, according to the BMJ research, and it’s potentially unsafe, according to Arthritis Australia.

Should pharmacists be outlining these concerns to each and every enquiry and prescription for high-dose paracetamol, or is it easier not to “rock the boat” by taking the money?

My patients actually tell me that they find their own pain experience reflects the BMJ finding – high-dose paracetamol doesn’t make a difference at all to their pain levels.