## 4 Discussion
 } & Ds (\(n\) = 25 & \multirow{3}{*}{-} & \multirow{3}{*}{2 (8.0)} & \multirow{3}{*}{-} & \multirow{3}{*}{3 (12.0)} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{2 (8.0)} & \multirow{3}{*}{-} \\  & \(=\) 100\% & & & & & & & & & \\ \hline \multirow{3}{*}{ \begin{tabular}{c} Lower \\ back \\ \end{tabular}  } & Ds (\(n\) = 64 & \multirow{3}{*}{-} & \multirow{3}{*}{2 (3.1)} & \multirow{3}{*}{5 (7.8)} & \multirow{3}{*}{-} & \multirow{3}{*}{2 (3.1)} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{5 (7.8)} & \multirow{3}{*}{-} \\  & \(=\) 100\% & & & & & & & & \\ \cline{1-1}  & \multirow{3}{*}{ \begin{tabular}{c} DAs \\ \end{tabular}  } & Ds (\(n\) = 89 & \multirow{3}{*}{1 (1.1)} & \multirow{3}{*}{1 (1.1)} & \multirow{3}{*}{5 (5.6)} & \multirow{3}{*}{-} & \multirow{3}{*}{3 (3.4)} & \multirow{3}{*}{1 (1.1)} & \multirow{3}{*}{2 (2.2)} & \multirow{3}{*}{-} & \multirow{3}{*}{5 (5.6)} & \multirow{3}{*}{4 (4.5)} \\  & \(=\) 100\% & & & & & & & & & \\ \cline{1-1}  & \multirow{3}{*}{ \begin{tabular}{c} DAs \\ \end{tabular}  } & Ds (\(n\) = 10 & \multirow{3}{*}{-} & \multirow{3}{*}{1 (10.0)} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{1 (10.0)} \\  & \(=\) 100\% & & & & & & & & \\ \hline \multirow{3}{*}{\ \begin{tabular}{c} Knee \\ \end{tabular}  } & Ds (\(n\) = 5 & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{1 (20.0)} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{1 (20.0)} & \multirow{3}{*}{-} \\  & \(=\) 100\% & & & & & & & & & \\ \hline \multirow{3}{*}{ \begin{tabular}{c} Ankle \\ \end{tabular}  } & Ds (\(n\) = 5 & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{-} & \multirow{3}{*}{3 (60.0)} \\  &were taken most frequently by the respondents, is not recommended due to a small increase in analgesic effect but a notable increase in side effects [32]. The knowledge of Ds and DAs on this subject could explain why in most cases only one agent was taken. Therefore, hypothesis 2 can be verified. The frequency of medication intake showed that Ds took their medication more irregularly but also more frequently as needed, depending on the region, while the DAs took their medication more frequently on a weekly basis. One reason for this is that the most commonly taken drugs from the NSAID class are not taken regularly over a long period of time because of the possible adverse effects; these include asthma attacks, increased risk of cardiovascular events or the loss of cytoprotective prostaglandandins and the associated damage to the gastric and intestinal mucosa [33]. Since DAs took their medication more frequently on a weekly basis and Ds more frequently as needed, hypothesis 3 has to be rejected. Compared to a previous study [20] on substance use in HCPs, little to no regular use of opioids was found in the present study. At this point it should be mentioned that in the present study the focus was on the use of medication for complaints caused by MSDs and not on the use of substances due to various other causes [20]. Since the aim of the present analysis was to investigate the use of drugs for pain relief from MSDs no statement can be made of the use of other drugs, such as alcohol or other substances due to other complaints. In addition, another study could investigate other causes or variables besides MSDs for taking medication, such as other illnesses of a DHP or the psychological and psychosocial components at the workplace of Ds or DAs. These facts would be another interesting topic for a future study among DHPs in Germany. All data, including those on the prevalence of the disease or on therapy, were self-reported by the respondents and not verified by HCPs.