Analgesics Prescribing Trends in Emergency and Out Patients at Tertiary Care Hospital – A Cross Sectional Study

Article / Short Article

Shahbaz Ahmad Khan1*, Omar Akhlaq Bhutta1, Ateeq-ur-Rehman Ghafoor2, and Saad Bin Zulfiqar3

1,2,3Department of Pharmaceutical Services, Shaukat Khanum , Memorial Cancer Hospital & Research Centre, Lahore, Pakistan

*Corresponding author :

Shahbaz Ahmad Khan
Department of Pharmaceutical Services
Shaukat Khanum Memorial Cancer Hospital & Research
Centre
Lahore
Pakistan
Submitted : 3 August 2020 ; Published : 26 August 2020

Abstract

Unnecessary or inappropriate prescription of analgesics specifically in emergency is a major concern. Sometimes inappropriate drugs are selected, as if opioid use in first place may cause serious side effects but also waste of precious drug in a country where availability of opioids is already in scarcity. Limited studies have examined the impact of analgesics prescribing trend in developing countries. In our setting, we examined the 5675 patients who visited emergency assessment room (EAR) or out-patient department (OPD) during the last 12 months and received different types of analgesics for their pain management. Out of 5675 patient’s prescription, there were only 105 prescriptions for morphine. This constitutes only 1.85 % of total prescriptions order out of 5675. Moreover, 3941 patients out of 5675 were managed with paracetmol plus tramadol combination. Nevertheless only 1629 patients received paracetmol & ibuprofen combination for their pain management. So from the above given prescription trend, we can say that if we evaluate the patients efficiently and prescribe analgesics according to pain scale, we can manage most of our patients without opioids. Proper analgesic prescribing will not only decrease opioids use but also decrease the suffering of patients.

Key Words: Analgesic Prescribing; Emergency; Morphine

Aims and Objectives

The aim of the study was to review the rational use of analgesic prescribed in EAR and OPD during of the hospital over one year period.

Methods

Retrospective, cohort study reviewing 5675 patients who were evaluated during the last one year during their visit in EAR or OPD for pain management. The date was collected through hospital information system and Microsoft excel was used to quantify the data.

Results

Only 105 prescription having morphine as opioids prescribed to manage pain. Out of 5675 prescriptions orders, only 1.85 % prescribed morphine, while 3941 patients were managed with paracetmol plus tramadol combination. Nevertheless only 1629 patients received paracetmol & ibuprofen combination for their pain management. Efficient use of analgesic prescribing will not only decrease opioids use but also decrease the suffering of patients.

Conclusion

Despite an oncology setup, the proportions of prescriptions having morphine were very small. Our findings support the need to further standardize and improve adherence to analgesic treatment guidelines. It will lead to better use of opioids drugs whose availability and misuse is always a concern worldwide.

Acknowledgments

Funding: No funding or sponsorship was received for this study or publication of this article.
Authorship: All named authors meet the Journal’s criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.
Compliance with ethics guidelines: This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Disclosures: Shahbaz Ahmed Khan, Omar Akhlaq Bhutta, Ateeq-ur-Rehman Ghafoor, and Saad Bin Zulfiqar have nothing to disclose.

Data Availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.