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. 2018 Sep 20:11:1959-1966.
doi: 10.2147/JPR.S164774. eCollection 2018.

Trends and patterns of analgesic prescribing in Malaysian public hospitals from 2010 to 2016: tramadol predominately used

Che Suraya Zin  1 , Nor Ilyani Nazar  1 , Norny Syafinaz Rahman  1 , Nor Elina Alias  1 , Wan Rohaidah Ahmad  2 , Nurul Sahida Rani  3 , Mary Suma Cardosa  4 , Kim Swan Ng  4 , Felicia Loh Ye  5
Affiliations

Trends and patterns of analgesic prescribing in Malaysian public hospitals from 2010 to 2016: tramadol predominately used

Che Suraya Zin et al. J Pain Res. .

Abstract

Purpose: To examine the trends of analgesic prescribing at public tertiary hospital outpatient settings and explore the patterns of their utilization in nonsteroidal anti-inflammatory drugs (NSAIDs), tramadol, and opioid patients.

Patients and methods: This cross-sectional study was conducted from 2010 to 2016 using the prescription databases of two tertiary hospitals in Malaysia. Prescriptions for nine NSAIDs (ketoprofen, diclofenac, celecoxib, etoricoxib, ibuprofen, indomethacin, meloxicam, mefenamic acid, and naproxen), tramadol, and five other opioids (morphine, fentanyl, oxycodone, dihydrocodeine, and buprenorphine) were included in this study. Annual number of patients and prescriptions were measured in repeat cross-sectional estimates. Descriptive statistics and linear trend analysis were performed using Stata version 13.

Results: A total of 192,747 analgesic prescriptions of the nine NSAIDs, tramadol, and five other opioids were given for 97,227 patients (51.8% NSAIDs patients, 46.6% tramadol patients, and 1.7% opioid patients) from 2010 to 2016. Tramadol (37.9%, n=72,999) was the most frequently prescribed analgesic, followed by ketoprofen (17.5%, n=33,793), diclofenac (16.2%, n=31,180), celecoxib (12.2%, n=23,487), and other NSAIDs (<4.5%). All the analgesics were increased over time except meloxicam, indomethacin, and mefenamic acid. Opioids, primarily morphine (2.2%, n=4,021) and oxycodone (0.5%, n=1,049), were prescribed the least, but the rate of increase was the highest.

Conclusion: Tramadol was the most frequently prescribed analgesic in hospital outpatient settings in Malaysia. Opioids were prescribed the least, but noted the highest increase in utilization.

Keywords: Malaysia; NSAIDs; analgesics; opioids; patterns; tramadol; trends of prescribing.

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Conflict of interest statement

Disclosure CSZ was supported by a research grant from The Ministry of Education Malaysia (Fundamental Research Grant Scheme, FRGS 15-195-0436). The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Number of prescriptions for NSAIDs, opioids, and tramadol from 2010 to 2016. Abbreviation: NSAIDs, nonsteroidal anti-inflammatory drugs.
Figure 2
Figure 2
Annual number of patients and number of prescriptions per patient for NSAIDs, opioids, and tramadol from 2010 to 2016. Abbreviation: NSAIDs, nonsteroidal anti-inflammatory drugs.
Figure 3
Figure 3
Prescribing of NSAIDs, opioids, and tramadol by issuing department. Abbreviations: NSAIDs, nonsteroidal anti-inflammatory drugs; O&G, obstetrics and gynecology.
See this image and copyright information in PMC

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