Pain-Prescription Differences - An Analysis of 500,000 Discharge Summaries

Preissner, Saskia; Siramshetty, Vishal B.; Dunkel, Mathias; Steinborn, Paul; Luft, Friedrich C.; Preißner, Robert

doi:10.2174/1874473711666180911091846

Cited by 9 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Utilization of different therapeutic analgesics groups according to duration of pain. *statistically significant at p < .05 rare but potentially fatal adverse event of agranulocytosis [9,14,15,32]. Metamizole has at least a potency similar to most NSAIDs [25], and when used short term, it is also the safer choice [33,34].…”

Section: Metamizolementioning

confidence: 95%

“…Adverse effects associated with opioids, such as constipation, respiratory depression, and addiction, can present a barrier to longterm treatment [8]. In recent years, the topic of analgesics use has received much attention in Europe [9][10][11][12][13][14]. However, the existing drug utilization studies, done on analgesics use in the older German population, either include only nursing home residents [15,16] or multi-morbid older adults [17], or focus on selected analgesics [13,18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pain severity and analgesics use in the community-dwelling older population: a drug utilization study from Germany

Nguyen

Laetsch

Chen

et al. 2020

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Purpose Chronic pain is common in the older population and a significant public health concern. However, comprehensive studies on analgesics use in this age group from Germany are scarce. This study aims to give a comprehensive overview on the use of the most common therapeutic groups of analgesics in community-dwelling older adults from Germany. Methods A cross-sectional study was carried out using data from a German cohort of 2038 community-dwelling adults aged 63-89 years. Descriptive statistics and logistic regression models were applied to assess the utilization of analgesics by age, sex, pain severity, pain duration, and locations. Results One out of four study participants was suffering from high-intensity or disabling pain. Approximately half of those taking analgesics still reported to suffer from high-intensity or disabling pain. Among analgesics users, occasional non-steroidal antiinflammatory drugs (NSAIDs) use was the most frequent pain therapy (in 43.6% of users), followed by metamizole (dipyrone) use (16.1%), regular NSAIDs use (12.9%), strong opioids use (12.7%), and weak opioids use (12.0%). In multivariate logistic regression models, higher age, higher pain severity, longer pain duration, abdominal pain, and back pain were statistically significantly associated with opioids use. Metamizole use was also statistically significantly associated with higher pain severity but inversely associated with pain duration. Conclusions A significant number of older German adults are affected by high-intensity and disabling chronic pain despite receiving analgesics. Long-term studies are needed to compare the effectiveness and safety of different treatments for chronic pain in older adults.

show abstract

Section: Metamizolementioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Pain severity and analgesics use in the community-dwelling older population: a drug utilization study from Germany

Nguyen

Laetsch

Chen

et al. 2020

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…2 Moreover, accurate discharge documentation can allow for large epidemiological studies to be performed (in healthcare systems set up to optimise usage of these documents). [3][4][5] Conversely, poor quality discharge summaries carry increased risks of a number of medical errors, including medication prescription errors and delays in outpatient reviews. [6][7][8][9] We identified that there was an unmet need for improvement in the quality of our trust's discharge summaries.…”

Section: Introductionmentioning

confidence: 99%

Improving the quality of discharge summaries through a direct feedback system

Earnshaw

Pedersen

Evans

et al. 2020

Future Healthcare Journal

View full text Add to dashboard Cite

Introduction There is a recognised need to improve the quality of discharge documentation to facilitate the safe and effective ongoing care of patients once they leave hospital. Previous studies have focused on individual interventions, such as teaching or feedback. Our continuous quality improvement project aims to improve the quality of discharge documentation at our hospital by providing a comprehensive overhaul of the education and feedback around discharge documentation. Methods We designed a comprehensive data analysis tool to analyse the performance of our discharge summaries. We presented at clinical governance sessions and arranged numerous teaching sessions for junior doctors. We developed a livefeedback system based on the content of a sample set of the previous month's summaries, which included poster-based feedback and group teaching. Results Our interventions have significantly improved the quality of our discharge documentation across a broad range of categories, including the summary of the stay, actions for general practitioners and information given to patients in lay terminology. Conclusion Our comprehensive quality improvement project has improved the quality of our discharge documentation. Further work aims to expand this project into a regional setting, as well as designing a strategy to maintain engagement of key stakeholders to ensure continued progress.

show abstract

“…3,6,[32][33][34][35] For instance, metamizole was the third most prescribed analgesic drug in Switzerland in the period between 2006 and 2013, and in Germany it was the most prescribed analgesic substance in 2012, with more than 140 million defined daily doses. 28,36 In countries where metamizole is sold over the counter, the drug is used as a common self-medication and is the most taken analgesic agent in patients with chronic pain. 37 A crosssectional population-based study performed in Brazil, where metamizole is sold over the counter, analyzed 41 433 individuals and revealed that metamizole is the most used self-medication.…”

mentioning

confidence: 99%

“…38,39 Figure 1 gives an overview of the legal status of metamizole worldwide according to the literature. 6,[28][29][30][31] Furthermore, it must be taken into account that metamizole is widely used by immigrants, even in countries where the substance is banned. 40 For instance, metamizole is a very common self-medication in Latino families in the United States and accordingly was the subject of several case reports.…”

mentioning

confidence: 99%

Metamizole (Dipyrone) and the Liver: A Review of the Literature

Lutz

2019

The Journal of Clinical Pharma

View full text Add to dashboard Cite

Metamizole, also known as dipyrone, was introduced to the market nearly a century ago. Due to its excellent analgesic, antipyretic, and spasmolytic properties combined with its mostly favorable gastrointestinal tolerability, the drug was extensively applied worldwide during the first decades after its market introduction. Although rare, agranulocytosis is a well‐known adverse event of metamizole and led to its withdrawal from the market in a number of countries beginning in the 1960s. Nevertheless, metamizole is still a frequently used drug worldwide either legally (by prescription in some countries, over the counter in other countries) or without official approval (especially by immigrants knowing the drug from their home countries) or even illegally (due to its growing application as an adulterant in illicit drugs). Metamizole undergoes extensive metabolism in the liver and cases of potential metamizole‐associated hepatotoxicity have been described. Here, the literature is extensively reviewed for the first time regarding hepatic effects associated with the use of metamizole.

show abstract

Pain-Prescription Differences - An Analysis of 500,000 Discharge Summaries

Abstract: The choice of pain relievers is varies regionally and is often in disagreement with approved indications and regulatory guidelines. A pronounced East-West gradient was observed with metamizole use and the opposite with prescription opioids.

Cited by 9 publications

References 19 publications

Pain severity and analgesics use in the community-dwelling older population: a drug utilization study from Germany

Pain severity and analgesics use in the community-dwelling older population: a drug utilization study from Germany

Improving the quality of discharge summaries through a direct feedback system

Metamizole (Dipyrone) and the Liver: A Review of the Literature

Contact Info

Product

Resources

About