A review of opioid prescription in a teaching hospital in Colombia

Moyano, Jairo; Figueras, Albert

doi:10.2147/jpr.s32603

Cited by 4 publications

(7 citation statements)

References 25 publications

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“…There were no life-threatening events, and the pattern of side effects was similar to that reported by McHale et al [28] on the use of narcotic analgesics. Although opiates can cause severe adverse effects, this is rare when they are administered in the recommended dose [9,18,23]. This statement is re-affirmed by the pattern of adverse effects in this study.…”

Section: Discussionsupporting

confidence: 76%

“…Furthermore, increased knowledge about the use of opiates has evolved. Despite this body of knowledge, preoperative analgesia is still avoided in patients with acute abdominal pain for fear of masking the pathology [8,9,13-18]. In keeping with the prediction in the current edition of Cope’s book that old habits may be difficult to kill in the matter of withholding analgesics in patients with acute abdomen [19], in Nigeria the traditional practice of withholding analgesia is still common [10,20].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative pain treatment in acute abdomen in Osogbo, Nigeria: a randomized double-blind placebo-controlled study

et al. 2013

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BackgroundWithholding analgesics in acute abdomen for fear of masking clinical features and impairing diagnosis and decision-making is still being practiced despite recent evidence to the contrary. This study assesses the effect of preoperative analgesia on clinical findings, clinical diagnosis, and decision-making in patients with non-trauma acute abdomen.MethodThis is a randomized, double-blind, placebo-controlled study using Tramal, a brand of tramadol, at the ED of LAUTECH Teaching Hospital Osogbo, Nigeria. Ninety-five patients between 18–60 years received Tramal (n = 46) or placebo (n = 49). The pain score, clinical findings, provisional diagnosis, and treatment plan were noted before and 15–20 min after administration of the analgesic or placebo. The final diagnosis arrived at after adequate investigation or operation was considered the gold standard. The pain scores, diagnosis, treatment plan, and decision between the two groups were compared. Statistical analysis was by SPSS 16. Results were considered statistically significant at p < 0.05.ResultsDemography and case distribution were similar in both groups. The improvement in pain was greater in the Tramal group (p = 0.001). The abdominal palpation findings were also better in the Tramal group (p = 0.02). There were more changes in the diagnosis after use of Tramal (p = 0.01). There were more changes in the decision in the Tramal group (p = 0.03). Most of the changes in diagnosis and decision in the Tramal group were for the better.ConclusionThe preoperative use of Tramal in acute abdomen improved the experience of pain and did not adversely affect the accuracy of the diagnosis or decision-making.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Preoperative pain treatment in acute abdomen in Osogbo, Nigeria: a randomized double-blind placebo-controlled study

et al. 2013

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“…In patients with chronic pain, pain management can help to maintain or to improve quality of life. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Prescription pattern of analgesic drugs for patients receiving Palliative Care in a Teaching Hospital in India

Menezes¹,

Nair²,

Soumya³

et al. 2016

Indian J Palliat Care

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Background:Drugs used in the palliative care unit for managing symptoms are major contributors toward the expenditure occurring in palliative care. This study was conducted to understand the prescription pattern of analgesic drugs in the patients who are receiving palliative care in a teaching hospital in India by a retrospective study of case records.Methods:Case record based, retrospective, descriptive study was conducted at the Pain and Palliative Care Department of St. John's Medical College Hospital, Bengaluru. Case record files of all patients referred to Pain and Palliative Care Department for the treatment of pain in the year of 2012 were studied. Patients’ age, gender, diagnoses, numerical pain rating scale (0–10), drugs prescribed, dosage, frequency, route of administration were recorded. The difference in drug utilization between the genders was done using Chi-square test. Data were collected from 502 patients of which 280 (56%) were males and 222 (44%) were females. Twelve percent of patients had mild pain (1–3), 34% had moderate pain (4–6), and 54% had severe pain (7–10). The most commonly used analgesic drugs were opioids (47%), followed by nonsteroidal anti-inflammatory drugs (36%). The opioids used were tramadol (56%), and morphine (38%). Ninety percent of patients with numerical pain scale more than 6 received morphine. There was no difference in analgesic drug utilization with regards to gender. Prescription pattern differed depending on the severity of pain. Opioids were the most commonly used drugs for pain management.Conclusion:The study shows that prescription pattern in palliative care unit of this hospital was in accordance with WHO pain management guidelines. The study showed the current trend in prescription of analgesic drugs in the teaching hospital where the study was conducted.

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“…Perhaps in Colombia we have problems with the availability of opioids in general (5,6), and being a country where social inequality is frequent, not only misinformation and widespread opiophobia, coupled with the lack of training tools for health providers who are also uninformed, explain the two most likely dangerous extremes (6): First, inadequate availability, prescription and monitoring of opioids in clinical settings where they are effective and safe (5). Second, prescription of opioids for diseases for which they have not proven to be effective, and they put the population before a huge public health problem, which has been documented in other countries.…”

Section: Discussionmentioning

confidence: 99%

“…One of the multiple causes of inappropriate prescription of opioids is the inadequate training and updating of the persons in charge (4,5). In Colombia there are paradoxical circumstances; for example, the inadequate availability of opioids (associated with the problem of pain control) in clinical circumstances where these have proven to be effective and safe; as well as the indiscriminate prescription of these in clinical contexts, where their effectiveness and safety are highly questioned (5,6).…”

Section: Introductionmentioning

confidence: 99%

Methadone Prescription Patterns among Pain Physicians in Colombia

2018

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Background: Chronic pain is a disease with serious consequences for people, physicians, and health care systems. Chronic opioid usage is one of the therapy strategies. Methadone is among the available opioids in Colombia and it is characterized by unique pharmacological properties and increased mortality reports because of overdose and cardiovascular complications. Appropriate monitoring and prescribing patterns of methadone are associated with complications similar to chronic management with other opioids. Aim: To describe methadone prescribing patterns among Colombian pain physicians and compare them to the accepted recommendations by the international scientific community. Materials and Methods: An electronic structured survey was applied to pain specialist physicians identified through major pain study associations and national training programs. Results: Respondents of the survey are mostly experienced university certified physicians and anesthesiologists with clinical training working at university hospitals. Most of them perceive chronic opioid therapy as an effective strategy for pain relief and functional outcomes despite the lack of empirical support. Most of them know clinical practice guidelines but are not applying them despite this matter. Conclusions: We must enhance education for prescribers in order to improve patient safety. The recommended clinical practice guidelines are poorly applied by Colombian doctors. The results of this study must be cautiously assessed.

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A review of opioid prescription in a teaching hospital in Colombia

Cited by 4 publications

References 25 publications

Preoperative pain treatment in acute abdomen in Osogbo, Nigeria: a randomized double-blind placebo-controlled study

Preoperative pain treatment in acute abdomen in Osogbo, Nigeria: a randomized double-blind placebo-controlled study

Prescription pattern of analgesic drugs for patients receiving Palliative Care in a Teaching Hospital in India

Methadone Prescription Patterns among Pain Physicians in Colombia

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