Pain-prescription differences - an analysis of 500,000 discharge summaries

Item Type:	Article
Title:	Pain-prescription differences - an analysis of 500,000 discharge summaries
Creators Name:	Preissner, S. and Siramshetty, V.B. and Dunkel, M. and Steinborn, P. and Luft, F.C. and Preissner, R.
Abstract:	BACKGROUND: Pain-relief prescriptions have led to an alarming increase in drug-related abuse. In this study we estimate the pain reliever prescription rates at a major German academic hospital center and compare with the nationwide trends from Germany and prescription reports from the USA. METHODS: We analysed >500,000 discharge summaries from Charite, encompassing the years 2006 to 2015, and extracted the medications and diagnoses from each discharge summary. Prescription reports from the USA and Germany were collected and compared with the trends at Charite to identify the frequently prescribed pain relievers and their world-wide utilization trends. The average costs of pain therapy were also calculated and compared between the three regions. RESULTS: Metamizole (dipyrone), a non-opioid analgesic, was the most commonly prescribed pain reliever at Charité (59%) and in Germany (23%) while oxycodone (29%), a semi-synthetic opioid, was most commonly ordered in the USA. Surprisingly, metamizole was prescribed to nearly 20% of all patients at Charite, a drug that has been banned for safety reasons (agranulocytosis) in most developed countries including Canada, United Kingdom, and USA. Large number of prospective cases with high risk for agranulocytosis and other side effects were found. Average cost of pain therapy greatly varied between the USA (125.3 EUR) and Charite (17.2 EUR). CONCLUSIONS: The choice of pain relievers is varies regionally and is often in disagreement with approved indications and regulatory guidelines. A pronounced East-West gradient was observed with metamizole use and the opposite with prescription opioids.
Keywords:	Chronic Pain, Drug-Related Abuse, Analgesic, Metamizole, Oxycodone, Agranulocytosis
Source:	Current Drug Abuse Reviews
ISSN:	1874-4737
Publisher:	Bentham Science Publishers
Volume:	11
Number:	1
Page Range:	58-66
Date:	2019
Official Publication:	https://doi.org/10.2174/1874473711666180911091846
PubMed:	View item in PubMed

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