An investigation into the prescribing of analgesics

Abstract

Objective: To investigate the prescribing of analgesic agents in a defined South African patient population. Design: Retrospective drug utilisation study. Setting. Prescribing behaviour of a sample of 50 dispensing doctors in Port Elizabeth. Data were obtained from a medical aid which used a formulary system. Main outcome measures: Percentage of central nervous system drugs that analgesics comprised; proportion of patients using combination analgesics; cost of analgesics. Results: On average, 83.3% of all central nervous system drugs dispensed were analgesic agents. These agents represented 70.9% of the total cost of central  nervous system drugs. A high percentage (82.2%) of the analgesic agents dispensed were combination or polycomponent analgesics. The combination analgesic tablet, consisting of paracetamol, meprobamate, caffeine and codeine phosphate, was the most frequently prescribed central nervous system drug. This product accounted on average for 40.4% of all analgesics dispensed. Nearly half (46.0%) of all the analgesics dispensed by the sample of doctors were available without a prescription. Conclusion: The high prescribing rate of combination analgesic prescription was a cause for concern, given the  dependence-producing potential of some of the ingredients, e.g. meprobamate. The prescribing and use of analgesics should be carefully monitored by further drug utilisation studies in light of the serious adverse effects, such as analgesic nephropathy, associated with the longtenn use of these agents.

S Afr Med J 1996; 86: 1394-1397