Estudio de utilización de analgésicos opiáceos en un hospital general universitario

Abstract

Objective The aim of this study was to analyze opioid analgesic use in the La Paz University Hospital in 2008 in order to identify patterns of use and consumption. To that end, data from inpatients were analyzed overall, as well as by hospitals and departments. We analyzed data on consumption in the previous 5 years and quantified the use of the remaining active principles administered as analgesics in our hospital. Materials and methods Following the Wold Health Organization's guidelines for studies on medication use in hospitals, data are shown as defined daily dose (DDD) per 100 hospital stays. Data on drug use were obtained from the drug management program, Farma Tools (Dominion®), which is used by the Pharmacy Service at La Paz Hospital. Results The overall value of opioid utilization in 2008 was 8.1 DDD per 100 hospital stays. The most widely used active principles were parenteral morphine and transdermal fentanyl. Together, these drugs represented 83% of total opioid consumption. Analysis by hospital revealed that the General and Traumatology Hospitals showed the highest opioid drug consumption and followed the same utilization pattern as overall use. The services most representative of opioid consumption in inpatients were the Recovery Room in the General and Traumatology Hospitals, Critical Care, Oncology, Hematology and Palliative Care. In the last 5 years of the study, the overall use of these drugs increased by 20%, irrespective of the active principles involved. Analysis of analgesic intake at La Paz Hospital showed widespread use (104 DDD per 100 hospital stays). Opioids represented 7.4% of total analgesic consumption, the most frequently used analgesics being acetaminophen and metamizol. Conclusions The results of our study show an increasing trend in opioid consumption in this hospital. We believe this increase reflects an improvement in the management of both acute and chronic pain, since the use of all opioid active ingredients increased. In hospitals with very high activity and complex clinical work, such as La Paz Hospital, this kind of study constitutes a specific tool that allows opioid use in distinct services and hospitals to be compared. This type of study also allows patterns of consumption and possible deviations to be identified and improvements to be made in the distinct clinical services involved in treating pain.