Open AccessA National Survey of Analgesic Prescribing Practices in the Acute Postoperative Pain Patient
Author(s) -
Trinca J,
McIntosh K,
Clavisi O,
Macintyre P,
Schug S,
Wai A
Publication year - 2007
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2007.00385_8.x
Subject(s) - medicine , pethidine , analgesic , acute pain , documentation , tramadol , service (business) , medline , medical emergency , intensive care medicine , family medicine , emergency medicine , anesthesia , economy , computer science , political science , law , economics , programming language
The National Prescribing Service (NPS) in collaboration with State DUE Groups is undertaking a quality improvement initiative aimed at improving A cute P ost O perative P ain management (the APOP project) in 63 Australian hospitals. Following discussions between NPS and ANZCA, it was decided to undertake a national survey of key acute pain service (APS) contacts to aid development of educational messages for the APOP project. The ANZCA Trials Group research co‐ordinator and NPS supported survey development and processing. Purpose of the study: To gain an understanding of what expert acute pain service clinicians see as common prescribing errors and poor pain management practice in the postoperative patient, and to investigate the degree of consensus which exists for specific aspects of basic analgesic prescribing, monitoring and documentation. Methods: A postal questionnaire consisting of an open question regarding prescribing errors and 27 opinion statements was sent to 144 key APS contacts across Australia. This group included medical and nursing co‐ordinators and a small group of clinical pharmacists with expertise in acute pain management. Opinion statements covered a range of topics including prescribing of opioids, tramadol, NSAIDs, and paracetamol, patient monitoring, and discharge medications. Results: A response rate of 74% was achieved, with extensive use of the open question and comments space. Common areas of concern included both under‐ and overdosing of opioids, use of multiple opioids via multiple routes, inappropriate dose intervals and under‐use of paracetamol. There were high levels of agreement regarding several opinion statements, particularly the inappropriate use of pethidine, but divergent views on others, such as the maximum daily dose of tramadol. Conclusions: The survey provided information to the APOP project by identifying areas of educational need, highlighting specific analgesic prescribing practices judged to be correct by most experts as well as highlighting those where there is a lack of consensus.