Prescribing Pattern and DrugâÂÂDrug Interactions of Analgesics Prescribed For Pain Management in a Pakistani Tertiary Hospital

Abstract

Background: The main strategy of analgesic therapy is to diminish the intensity of pain to bearable level. Guidelines have been established by WHO to reduce the possible medication error in analgesic therapy. However, in most of the hospitals in Pakistan, analgesics are not prescribed rationally in accordance with standard guidelines. Objectives: The purpose of this study is to analyze therapeutic strategy of pain management in patients hospitalized at a tertiary hospital, as an exemplary assessment of prescribing pattern of analgesics, and to estimate the prevalence of potential drug–drug interaction there in. Methodology: This is a non-interventional cross sectional study of patients hospitalized in surgical and oncology wards of an urban Pakistani tertiary care hospital. The prescriptions were analyzed for physicians' preferences for the choice of analgesics and number of analgesics prescribed. Moreover, general observation was made whether pain intensity assessment tools were employed before prescribing analgesics. The effectiveness of prescribed analgesics was assessed by interviewing the patients post analgesic therapy. Furthermore, potential drug–drug interactions were also studied using reference books and Medscape Multi Drug interaction checker. Results: In the study population of n=45 inpatient (24 male and 21 female). Tramadol was the most frequently prescribed analgesic. In none of the case pain intensity was assessed before prescribing analgesics, hence, 53.3% subjects complained about severe pain even after analgesic therapy. Potential drug–drug interactions were present in all the prescriptions. Ultimately, 276 interactions were found in 45 prescriptions, among which 60% were of major severity. Conclusion: In current study, poor management of pain was identified in a tertiary hospital in Pakistan. The analgesics were prescribed without actually assessing the pain intensity. Improper analgesic regimen was selected and too many interacting drugs were prescribed simultaneously.