Cost-Effectiveness of Two Painkillers for Treating Pain After Limb Injuries
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Purpose
Background: Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are commonly used oral analgesics in emergency departments (ED) not only in Hong Kong but throughout the world. There are no large-scale (n>100), prospective, randomised studies comparing paracetamol with ibuprofen in the management of acute soft tissue injury.
As paracetamol is cheaper than most NSAIDs, may be as effective in the management of acute pain and possibly with fewer adverse effects, a large-scale, randomised, controlled trial is needed to answer questions of relative analgesic efficacy, safety and cost-effectiveness. Previous comparative studies on NSAIDS have been done in this unit and have suggested equivalence between two NSAIDs and paracetamol, but numbers were small and drug doses were modest.
Objective: To compare the efficacy, safety and cost between oral ibuprofen and paracetamol in pain control for acute soft tissue injuries in an ED setting
Design: Prospective, double-blind, randomised controlled trial with three arms: oral paracetamol with placebo; oral ibuprofen with placebo; paracetamol and ibuprofen in combination
Participants: 783 subjects having sustained isolated soft tissue limb injury without significant fracture presenting to the ED of Prince of Wales Hospital
Main outcome measures: Pain relief profiles of paracetamol, ibuprofen and the combination of both; adverse effect profiles of paracetamol, ibuprofen and the combination of both; overall cost effectiveness of paracetamol, ibuprofen and the combination of both from the perspective of the healthcare provider
| Condition | Intervention | Phase |
|---|---|---|
|
Soft Tissue Injuries |
Drug: Paracetamol Drug: Ibuprofen Drug: Paracetamol Placebo Drug: Ibuprofen placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Cost-Effectiveness Analysis of Oral Paracetamol and Ibuprofen for Treating Pain After Soft Tissue Limb Injuries: Double-Blind, Randomised Controlled Trial |
- analgesic efficacy both at rest and with movement [ Time Frame: 72 hours ]
- presence, frequency and duration of adverse effects; cost-effectiveness analysis; patient satisfaction with analgesia [ Time Frame: 30 days ]
| Estimated Enrollment: | 783 |
| Study Start Date: | January 2005 |
| Study Completion Date: | December 2008 |
| Primary Completion Date: | December 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Drug: Paracetamol
1g qid
Drug: Ibuprofen placebo
Equivalent to 400mg tid
|
| Experimental: 2 |
Drug: Ibuprofen
400mg tid
Drug: Paracetamol Placebo
equivalent to 1g qid
|
| Experimental: 3 |
Drug: Paracetamol
1g qid
Drug: Ibuprofen
400mg tid
|
Eligibility| Ages Eligible for Study: | 16 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- All patients >16 years presenting to the ED with isolated soft tissue injury without significant fracture
- between 9am to 5pm, Monday to Friday,
Exclusion Criteria:
History of :
- peptic ulceration or hemorrhage
- recent anticoagulation
- pregnancy
- adverse reaction to paracetamol or ibuprofen
- renal or cardiac failure
- hepatic problems
- rectal bleeding
- chronic NSAID consumption
- asthma
- chronic obstructive pulmonary disease
- chronic pain syndromes
- prior treatment with analgesia for the same injury
- physical, visual or cognitive impairment making use of the visual analogue scale unreliable
Contacts and Locations| Hong Kong | |
| Prince of Wales Hospital | |
| Sha Tin, NT, Hong Kong | |
| Principal Investigator: | Colin A Graham | Chinese University of Hong Kong |
More Information
No publications provided
| Responsible Party: | Colin A Graham, Chinese University of Hong Kong |
| ClinicalTrials.gov Identifier: | NCT00528658 History of Changes |
| Other Study ID Numbers: | HKCEM06-07/DG2041095, HKCEM Grant 2006-07, CUHK DG 2041095 |
| Study First Received: | September 11, 2007 |
| Last Updated: | January 28, 2009 |
| Health Authority: | Hong Kong: Joint CUHK-NTEC Clinical Research Ethics Committee |
Keywords provided by Chinese University of Hong Kong:
|
Soft Tissue Injuries |
Additional relevant MeSH terms:
|
Soft Tissue Injuries Wounds and Injuries Acetaminophen Ibuprofen Antipyretics Physiological Effects of Drugs Pharmacologic Actions Analgesics, Non-Narcotic Analgesics Sensory System Agents |
Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses Anti-Inflammatory Agents, Non-Steroidal Anti-Inflammatory Agents Antirheumatic Agents Cyclooxygenase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 23, 2013