A Descriptive Research on Drug Use Pattern of Narcotic Analgesics: a Case of University Hospital in Korea

마약성 진통제의 사용양상에 관한 서술적 조사연구: 한 대학병원의 경우

  • Rah, Mi-Sook (Graduate School of Clinical Pharmacy, Yeungnam University) ;
  • Yoo, Bong-Kyu (College of Pharmacy, Yeungnam University)
  • Received : 2010.12.03
  • Accepted : 2011.03.22
  • Published : 2011.03.31

Abstract

The objective of this study was to find out drug use pattern of narcotic analgesics in university hospitals in Korea. A university hospital located in Kyungbuk province was chosen for this study. The drug use pattern was analyzed in terms of ingredient, administration route, patient type, and attending department. Amount of drug usage was counted by unit dose defined by the number of ampule or vial for injectable, tablet or capsule for oral, and each for patch preparations. Result showed that 11 narcotic analgesic ingredients were used during 2007-2009, and the drug usage was increased by about 20% annually during the period. Proportion of oral preparations used for pain management was about two third of all narcotic analgesics usage and kept increasing during the period. Proportion of the drug usage for outpatients was also steadily increased. Notably, the usage of oral preparations of oxycodone, morphine, and hydromorphone was rapidly increased for the management of cancer pain while the usage of codeine and codeine-containing composite preparations for cancer pain were minimal (<10%). About 90% of all narcotic analgesics were used by physicians in Internal Department, especially in Oncology Division of the Department. These findings suggest that pain management is becoming more aggressive and in agreement with WHO's guidelines regarding selection of administration route. However, in terms of 3-step ladder for cancer pain management, the drug use pattern was not congruent to WHO's guidelines. Therefore, in conclusion, it appears that physicians need to try to be congruent to the guidelines when using narcotic analgesics for cancer pain.

Keywords

References

  1. Baumann TJ. Pain management. In: Dipiro JT, ed. Pharmacotherapy: a pathophysiologic approach. 6th ed. New York: McGraw-Hill, 2005: 1089-104
  2. http://www.who.int/cancer/palliative/painladder/en/(accessed on November 30, 2010).
  3. Jost L, Roila F, ESMO Guidelines Working Group. Management of cancer pain: ESMO clinical recommendations. Ann Oncol 2008; Suppl 2: ii119-21.
  4. 유양숙, 최상옥, 조영이, et al. 일반인의 통증관리 장애정도. 한국 호스피스 완화의료학회지 2007; 10: 184-9.
  5. 한국 호스피스 완화의료학회, 대한항암요법연구회. 암성통증 관리지침. 군자출판사 (2001).
  6. 보건복지부. 암성 통증관리지침 권고안 4개정. available at http://www.cancer.go.kr/cms/data/edudata/__icsFiles/afieldfile/2010/05/27/Cancer_Pain_management_guideline(Dr).PDF (accessed on November 30, 2010).
  7. http://kostat.go.kr/wnsearchNew/search.jsp (accessed on November 30, 2010).
  8. 이효진, 진선아, 윤각원, et al., 암환자의 통증치료에 대한 Ultracet의 유효성과 안전성. 한국 호스피스 완화의료학회지 2006; 9: 101-5.
  9. 이소우, 김현숙, 김시영, et al., 암성통증관리 만족도. 한국 호스피스 완화의료학회지 2003; 6: 22-33.
  10. 이건세, 주지수, 김정회, et al., 한국 호스피스 완화의료기관 현황 및 과제. 한국 호스피스 완화의료학회지 2008; 11: 196-205.
  11. Lema MJ, Foley KM, Hausheer FH. Types and epidemiology of cancer-related neuropathic pain: the intersection of cancer pain and neuropathic pain. Oncologist 2010; 15 Suppl 2: 3-8.
  12. Reville B, Axelrod D, Maury R. Palliative care for the cancer patient. Prim Care 2009; 36: 781-810. https://doi.org/10.1016/j.pop.2009.07.010