약학회지 (YAKHAK HOEJI)

  • 제58권4호
  • /
  • Pages.268-276
  • /
  • 2014
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  • 0377-9556(pISSN)
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  • 2383-9457(eISSN)
대한약학회 (The Pharmaceutical Society of Korea)
권호 표지

단일 상급종합병원에서 마약성 진통제의 최근 13년간 사용 경향 조사

Trends in the Consumption of Opioid Analgesics in a Tertiary Care Hospital from 2000 to 2012

  • Cho, Yoon Sook (College of Pharmacy, Dongguk University) ;
  • Lee, Ju-Yeun (College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University) ;
  • Kim, Hyang Sook (College of Pharmacy, Dongguk University) ;
  • Kwon, Kyenghee (College of Pharmacy, Dongguk University)
  • 투고 : 2014.03.07
  • 심사 : 2014.08.19
  • 발행 : 2014.08.30
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초록

Background: World Health Organization considers opioid analgesic use as an important measure in the treatment of pain relief. However, there are limited data about the pattern of opioid analgesic use in tertiary care hospitals in Korea. The aim of this study was to describe the trends in the prescribed amount of the opioid for 13 years from 2000 to 2012 in a single tertiary care hospital. Methods: The data from the prescribed amount of opioid use in patients aged over 18 years were retrieved from medical charts and longitudinal pharmacy records of Seoul National University Hospital. Yearly prescribed amount of opioids were calculated using defined daily dose adjusted by hospital stay (DDD/1000${\bullet}$HS). Results: Over the 13 years of the study period, overall use of opioid has increased by 64.1%. Although, the opioid use by hospitalized patients comprised 98%~99% of total amount of opioid use, the proportions of opioid use by outpatient and by cancer patient increased from 1.1% to 2.2% and from 60.5% to 69.3%, respectively. The use of non-injectable opioids has increased by 47% and that of injectables has increased by 70%. While the amount of codeine and morphine use has decreased, the use of both transdermal and injection formulation of fentanyl has increased dramatically. Also, the use of oxycodone has increased, especially in outpatient setting. Conclusion: This longitudinal study showed that opioid analgesic use in tertiary hospital, especially in outpatient is continuously increasing. Improvement in pain management in tertiary care hospital can be cautiously inferred based on this results.

키워드

참고문헌

  1. Cicero, T. J., Inciardi, J. A. and Munoz, A. : Trends in abuse of Oxycontin and other opioid analgesics in the United States: 2002-2004. J. Pain 6, 662 (2005). https://doi.org/10.1016/j.jpain.2005.05.004
  2. Cicero, T. J., Inciardi, J. A. and Surratt, H. : Trends in the use and abuse of branded and generic extended release oxycodone and fentanyl products in the United States. Drug. Alcohol. Depend. 91, 115 (2007). https://doi.org/10.1016/j.drugalcdep.2007.05.008
  3. Garcia del Pozo, J., Carvajal, A., Viloria, J. M., Velasco, A. and Garcia del Pozo, V. : Trends in the consumption of opioid analgesics in Spain. Higher increases as fentanyl replaces morphine. Eur. J. Clin. Pharmacol. 64, 411 (2008). https://doi.org/10.1007/s00228-007-0419-9
  4. Spiller, H., Lorenz, D. J., Bailey, E. J. and Dart, R. C. : Epidemiological trends in abuse and misuse of prescription opioids. J. Addict. Dis. 28, 130 (2009). https://doi.org/10.1080/10550880902772431
  5. Baek, J. H. and Kwon, K. H. : The study of reasonable management of controlled drugs through a comparative analysis of management guidelines both domestic and abroad. J. Kor. Soc. Health-Syst. Phamr. 30, 141 (2013).
  6. Ponizovsky, A. M., Marom, E., Zeldin, A. and Cherny, N. I. : Trends in opioid analgesics consumption, Israel, 2000-2008. Eur. J. Clin. Pharmacol. 67, 165 (2011). https://doi.org/10.1007/s00228-010-0932-0
  7. Cancer pain relief: With a guide to opioid to availability (1996). Available from http://www.uicc.org/cancer-pain-relief-guideopioid-availability.
  8. International Narcotics Control Board. Annual report: Report of the International Narcotics Control Board for 2008. Available from http://www.incb.org/incb/en/annual_report.html.
  9. Paregeom, K. L. and Hailey B. J. : Barriers to effective cancer pain management: a review of the literature. J. Pain Symptom Manage. 109, 281 (1999).
  10. Korea Ministry of Health and Welfare. Ministry of Health and Welfare statistical yearbook 2012. Seoul: Korea Ministry of Health and Welfare (2012).
  11. Ministry of Health and Welfare. 2012 annual report of cancer statistics in Korea. Seoul: Ministry of Health and Welfare (2012).
  12. Park, Y. M. and Cho, N. C. : Analysis of narcotic use and pharmacists work to manage the narcotics in tertiary care hospital. J. Kor. Soc. Health-Syst. Phamr. 16, 512 (1999).
  13. Raha, M. S. and Yoo, B. K. : A descriptive research on drug use pattern of narcotic analgesics: a Case of University Hospital in Korea. Kor. J. Clin. Pharm. 21, 30 (2011)
  14. Guidelines for ATC classification and DDD assignment (2013). Available from http://www.whocc.no/atc_ddd_publications/ guidelines/.
  15. Hudec, R., Tisonova, J., Foltan, V. and Kristova V. : Consumption of three strong opioids (morphine, oxycodone and fentanyl) in seven European countries during seven years (2003-2009). Bratisl. Lek. Listy. 114, 581 (2013).
  16. Comments on the reported statistics on narcotic drugs (2013). Available from http://www.incb.org/documents/Narcotic-Drugs/ Technical-Publications/2012/NDR_2012_Part2_Comments_E.pdf.
  17. Fallon, M., Hanks, G. and Cherny, N. : Principles of control of cancer pain. B.M.J. 332, 1022 (2006). https://doi.org/10.1136/bmj.332.7548.1022
  18. Tassinari, D., Sartori, S., Tamburini, E., Scarpi, E., Tombesi, P., Santelmo, C. and Maltoni, M. : Transdermal fentanyl as a frontline approach to moderate-severe pain: a meta-analysis of randomized clinical trials. J. Palliat. Care 25, 172 (2009).
  19. Centeno, C., Portela, M. A., Noguera, A., Idoate, A. and Rubiales, A. S. : Impact of a new palliative care consultation team on opioid prescription in a University Hospital. BMC Palliat. Care 8, 2 (2009). https://doi.org/10.1186/1472-684X-8-2
  20. Regev, D., Eisenberg, E., Tansky, A. and Hadad, S. : Opioid consumption in a tertiary hospital setting over an 8-year timeframe--a potential resource for tracking trends in pain management. J. Pain Palliat. Care Pharmacother. 25, 113 (2011). https://doi.org/10.3109/15360288.2011.558992