Original Article

Evaluation of Parenteral Opioid Analgesics Utilization in Patients Hospitalized in a Referral Teaching Hospital


Background: Opioid drugs are the most effective drugs for the treatment of moderate to severe pain. Rates of opioid use are influenced by a variety of factors. The aim of this study was to determine the pattern of use of parenteral opioid drugs in hospitalized patients in a referral teaching hospital.
Methods: In a retrospective study, required data were extracted from medical records of adult patients who had received any parenteral opioid analgesic in the 6-month period from March 2013 to September 2013. The Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD) system method was used for evaluation of opioid analgesic use in patients.
Results: The overall usage of parenteral opioid analgesics was 730.51 DDDs with meperidine (Pethidine) having the most amounts of use (588.69 DDDs and 33.23 DDDs/100 bed-days). Overall, the male surgery ward and emergency department had the most amounts of use based on the number of DDDs (445.8 DDDs) and per 100 bed-days (1046 DDDs/100 bed-days), respectively. Methadone use was most in the infectious diseases ward.
Conclusion: The trend of parenteral opioid analgesics consumption is increasing in this hospital. Therefore, better adherence to pain treatment guidelines by medical staff is necessary for rational use of these drugs.

Duthey B, Scholten W. Adequacy of opioid analgesic consumption at country, global, and regional levels in 2010, its relationship with development level, and changes compared with 2006. J Pain Symptom Manage 2014;47(2):283-97.

Dhalla IA, Mamdani MM, Sivilotti ML, et al. Prescribing of opioid analgesics and related mortality before and after the introduction of long- acting oxycodone. Can Med Assoc J 2009;181(12):891-6.

Neutel CI, Skurtveit S, Berg C, Sakshaug S. Multiple prescribers in older frequent opioid users-does it mean abuse? J Popul Ther Clin pharmacol 2013;20(3):e397-405.

Fischer B, Jones W, Rehm J. Trends and changes in prescription opioid analgesic dispensing in Canada 2005-2012: an update with a focus on recent interventions. BMC Health Serv Res 2014;14(1):90.

International Narcotics Control Board (INCB): Narcotic Drugs Technical Report: Estimated World Requirements for 2013. New York, NY: United Nations; 2013.

Lohman D, Schleifer R, Amon JJ. Access to pain treatment as a human right.BMC Med 2010;8:8.

Natsch S, Hekster Y, De Jong R, et al. Application of the ATC/DDD methodology to monitor antibiotic drug use. Eur J Clin Microbiol Infect Dis 1998;17(1):20-4.

Wessling A, Boethius G. Measurement of drug use in a defined population.Eur J Clin Pharmacol 1990;39(3):207-10.

Russell JA, Leng G, Coombes JE, et al. Pethidine (meperidine) inhibition of oxytocin secretion and action in parturient rats. Am J Physiol 1991;261(2Pt 2):R358-68.

The selection and use of essential medicines. World Health Organization technical report series. 2011 (965):i-xiv, 1-249.

World Health Organization, Group ISoHW. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 2003;21(11):1983-92.

Gómez Salcedo P, Herrero Ambrosio A, Muñoz y Ramón JM. Estudio de utilización de analgésicos opiáceos en un hospital general universitario. Rev Soc Esp Dolor 2009;16(7):373-80.

Simó RM, Seijó F, Esteban MC. Evolución de la utilización de analgésicos en un hospital general. Comunicación XXXI Congreso Nacional de la Sociedad Española de Farmacia Hospitalaria. 1986.

Vadivelu N, Mitra S, Narayan D. Recent Advances in Postoperative Pain Management. Yale J Biol Med 2010; 83(1): 11–25.

Apfelbaum J, Chen C, Mehta S, Gan T. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003;97(2):534-40.

McQuay H. Opioids in pain management. Lancet 1999;353:2229–32.

Brunton LL, Parker K, Blumenthal D, Buxton I. Goodman & Gilman’s manual of pharmacology and therapeutics, 1st ed., 2008; New York, McGraw-Hill, p. 363.

IssueVol 3, No 1-2 (Spring 2015) QRcode
SectionOriginal Article(s)
Drug Utilization Evaluation Parenteral Opioid Drugs Hospitalized Patients

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Soltani R, Vatanpour H, Shafiee F, Sadeghian N. Evaluation of Parenteral Opioid Analgesics Utilization in Patients Hospitalized in a Referral Teaching Hospital. J Pharm Care. 3(1-2):16-20.