단일 상급종합병원에서 마약성 진통제의 최근 13년간 사용 경향 조사

Abstract

Background: World Health Organization considers opioid analgesic use as an important measure in the treatmentof pain relief. However, there are limited data about the pattern of opioid analgesic use in tertiary care hospitals inKorea. The aim of this study was to describe the trends in the prescribed amount of the opioid for 13 years from 2000 to2012 in a single tertiary care hospital. Methods: The data from the prescribed amount of opioid use in patients aged over18 years were retrieved from medical charts and longitudinal pharmacy records of Seoul National University Hospital. Yearlyprescribed amount of opioids were calculated using defined daily dose adjusted by hospital stay (DDD/1000•HS). Results:Over the 13 years of the study period, overall use of opioid has increased by 64.1%. Although, the opioid use by hospitalizedpatients comprised 98%~99% of total amount of opioid use, the proportions of opioid use by outpatient and by cancerpatient increased from 1.1% to 2.2% and from 60.5% to 69.3%, respectively. The use of non-injectable opioids has increasedby 47% and that of injectables has increased by 70%. While the amount of codeine and morphine use has decreased, theuse of both transdermal and injection formulation of fentanyl has increased dramatically. Also, the use of oxycodone hasincreased, especially in outpatient setting. Conclusion: This longitudinal study showed that opioid analgesic use in tertiaryhospital, especially in outpatient is continuously increasing. Improvement in pain management in tertiary care hospital canbe cautiously inferred based on this results.