Pain is a complex, subjective experience associated with actual or potential tissue damage. Non-opioid analgesics are used to relieve mild pain, while opioid analgesics are added to relief moderate to severe pain. The consumption of opioid analgesics in Slovenia is increasing. It is necessary to monitor the prescription and administration of drugs to prevent the most common mistakes in inadequately treated pain. Monitoring the administration is as important as monitoring the prescribing, because despite the precription, the patient may not recieve the analgesic. Compliance with administration and proper recording in the Narcotics Consumption Book is crucial for opioid analgesics. The aim of our research was a retrospective analysis of the adequacy of opioid analgesic prescribing and administration in the Murska Sobota General Hospital across individual departments over a one month period (June 2023).
The total number of patients from all departments who met the inclusion criteria was 202. In the analysis of opioid prescriptions we examined 218 prescriptions across all departments, focusing on the first prescription upon the initiation of opioid analgesics. In total, we analyzed 375 administered doses, of which 214 were intravenous, 154 oral, and 7 transdermal doses, within a 24-hour period from the first administration.
In the analysis of opioid analgesic prescriptions, we found that the majority of prescriptions were in accordance with the Medication Prescription Guidelines. However, certain deviations were observed in the recording of temporary interruptions or discontinuations of drug administrations, as these were appropriately recorded in only 18,8 % of cases. In 28,0 % of prescriptions, there were incomplete records regarding the form of the drug, although this does not necessarily correlate with the incorrect administration of the drug, as some drugs are only available on the market in one pharmaceutical form. Additionally, 20.6 % of prescriptions lacked information about the diagnosis, 13.3 % did not indicate the dosing interval, and 11.9 % did not specify the route of administration. The "as needed" prescription was inappropriate in 40.4 % of cases. The most significant deviations with intravenous opioid analgesics were observed in the timing of administration, especially at night, with an average delay of 5,4 hours or administration 2,7 hours too early. In 86.0%, the correct intravenous doses were administered, the remaining 14.0% can be attributed mainly to the fact that, on average, higher doses were administered than those prescribed. For orally administered opioid analgesics, the most inconsistencies were observed regarding the timing of administration, as in 35.1 % of cases, the administration time was not recorded. Overall, a 76.3 % compliance between the Narcotics Consumption Book and the therapeutic sheets was observed in the departments, with the remaining 23,7 % primarily attributed to errors related to dose appropriateness, although the total daily dose administered corresponded to the prescription. In some instances, errors were found in recording the date and unrecorded doses in the Narcotics Consumption Book compared to the therapeutic sheet.
Regular education and frequent monitoring of opioid analgesic prescribing and administration in hospital departments by pharmacists have proven necessary to ensure quality patient care.
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