Individualised Medication Effectiveness Tests for Chronic Pain.

The Centre for General Practice (CGP) at the University of Queensland Medical School operates the IMET Service. IMETs (Individualized Medication Effectiveness Tests) are designed to determine which medications are best for individuals. Some pain medications work differently for different people, and this means that some people taking medicines for chronic pain aren't getting any benefit from them. It is very difficult for doctors to find out which medicine is best just by trying them out one after the other because this isn't very reliable. It is much better to compare different medications objectively with an IMET. An IMET is essentially a short medical trial lasting 6 or 12 weeks in which a medication is alternated on a weekly basis with either placebo (identical in appearance but with no effect) or another pain medication. Neither IMET Service staff nor the patient is aware of which weeks they are taking the real medicine. The patient is asked to record how they feel in short diaries during these periods. We can also compare two real medications in the same way. After the IMET, the order of real and placebo medication is compared to the diary recordings are the results are used to determine if the medication benefits that person individually. If the patient says that they feel better when they are taking the real medicine then he/she is a responder. If there is no real difference between the way the patient feels when they are taking the placebo and the real medicine, then the medication isn't likely to be doing them any good. We call these people 'non-responders'. If a patient is a responder, they can keep on taking the medication and feel confident that it is the better one for them. If they are a non-responder, another medication will be of more benefit. Using the IMET process, it is possible for a doctor and patient to find the best medication to treat chronic pain for the individual patient. This trial offers IMETs for Actiprofen and Panadol, two common pain medicines. The reason for this is that some anti-inflammatory pain medications produce unwanted side effects for some people. If it is possible for people to have good pain relief from paracetamol or Actiprofen, or both, then this is a better option. This also has the potential to save the government health budget substantial amounts of money.