한 상급종합병원 내 Fentanyl Buccal Tablet의 의존 경향 파악 및 위험 요인 분석

Abstract

Background and Objective : Previous studies on the safety of fentanyl buccal tablets (FBT) have often dismissed patients with a high likelihood of drug abuse or who have been strongly controlled by dose or usage of FBT. For these reasons, we could not confirm the current state of dependence or addiction of opioid pain medication in patients suing FBT in an actual clinical setting. The purpose of this study was to analyze the FBT use status in a tertiary hospital in Korea and the risk factors related opioid dependence tendency and to contribute to the safe use of FBT. Methods : We retrospectively reviewed electronic medical records of cancer patients admitted to the wards that received FBT at a tertiary hospital in Korea From January to May 2018. The proportion of patients with dependence tendency due to FBT was investigated. Logistic regression analysis was performed to determine the risk factors. The significance level was p 0.05. Results : Of the total 275 patients, four had FBT dependence tendency, with a ratio of 1.45%. Additionally, smoking history (odds ratio=23.51, p=0.02) and one-day immediate opioid analgesic dose excluding FBT (odds ratio=1.15, p=0.01) were the risk factors for dependence tendency on opioid analgesic due to FBT. Conclusions : The proportion of patients with dependence tendency due to FBT in a tertiary hospital at Korea was 1.45%, which was higher than the general incidence of dependence or addiction of opioid analgesics used to mitigate cancer pain. Thus, patients taking this drug should be closely monitored for dependence and addiction. Additionally, medical staffs must be fully aware of patients’risk factors. Although this study has limitations as a retrospective study, it may be reliable data for the safe use of opioid analgesic by confirming the dependence tendency and risk factors of FBT in clinical practice.