Pain management in the medical specialty clinics of a university teaching hospital: A drug utilization study

Abstract

Background: The treatment of pain is largely determined by understanding the type of pain. A thorough understanding of analgesic prescriptions in specialized clinics may reflect the physicians' ability to effectively manage pain. This study aimed to investigate physicians' prescription pattern of analgesics and co-analgesics in a multispecialty internal medicine out-patient department.

Methods: This was a retrospective evaluation of dispensed medications containing analgesics and/or co-analgesics generated from the various specialized clinics of the Medical Out-Patient Department (MOPD) of the University of Benin Teaching Hospital from January 2021 to December 2021. These medications were classified according to the World Health Organization -Anatomic Therapeutic Chemical (WHO-ATC) classification system and evaluated using the WHO analgesic ladder and the guidelines for pain management in Nigeria. Data is presented descriptively.

Results: A total of 25837 medicines were dispensed during the period. Of which, 2311 (8.9%) were analgesics and co-analgesics. The mean age (SD) of patients issued these medicines was 63.6 (±13.8) years with majority aged 60 and above, 1592 (68.9%). Co-analgesics were the most dispensed medicines 1346 (58.2%) followed by non-opioids 705 (30.5%). Most NSAIDs dispensed were naproxen 112 (4.8%) while codeine was the most dispensed opioid 225 (9.7%). Majority of the non-opioid and co-analgesic prescriptions 742 (36.1%) were generated from the Neurology Clinic, while opioids were largely from Nephrology and Endocrinology Clinics 48 (18.5%).

Conclusion: The medical specialty clinics prescription pattern of analgesics suggests a rational approach to pain management. There is however a need to address the low utilization of opioid analgesics in pain management.