Pattern of morphine prescription by doctors in a Nigeria tertiary hospital

Background: Morphine was reintroduced into Nigeria after a long period of absence due to technical problems relating to stock accounting. With this reintroduction, prescriber education was commenced in many centers including the University of Ibadan. Aims and Objective: The aim of this study is to review the morphine prescription habits of the medical doctors practicing at the University College Hospital, Ibadan, and to assess the level of conformity with international guidelines. Materials and Methods: All the prescriptions on oral morphine in the hospital’s pharmacy records within a 6 months period were reviewed. Results: The results showed that more than half (51.7%) of all morphine prescriptions were from the Radiation Oncology Department, while the newly created Day Care Hospice Unit accounted for 31.8% of the prescriptions. No prescriptions were seen from the Labor ward. Only 1.1% of all the prescriptions conformed to international guideline as contained in the “Blue Book.” Conclusion: The results showed that there is a need for more education and advocacy programmes to increase awareness among doctors about morphine prescriptions.Keywords: Audit, doctors, morphine, Nigeria, prescriptionsNigerian Journal of Clinical Practice • Jan-Mar 2012 • Vol 15 • Issue

Evaluation of surgical resident staff knowledge of cancer pain: Assessment and treatment

Objective: Inadequate knowledge and expertise are major contributing factors to poor pain management in the cancer patient. This study was carried out to evaluate the effect of formal teaching on pain management on the current practice of the resident surgeons at the University College Hospital (UCH). Ibadan. Method: Resident surgeons at different levels of their 4-year program responded to a questionnaire, which requested them to state their management of a hypothetical patient who had severe cancer pain and also asked questions on other issues relating to cancer pain therapy. Results: Sixteen resident doctors responded to the questionnaire. Mean number of years spent in residency was 2.1. More than 80% of the respondents had adequate knowledge of just taking the basic history of pain. Less than 50% indicated the need to seek information about associated symptoms, previous pain history, and the psychosocial history of the patient. Only 37% would examine the patient. On the general knowledge section, 11 (68%) of the respondents recommended parenteral opioids while only 9 prescribed oral opioids. Ten (69.5%) respondents prescribed NSAIDS in addition to opioids. All the resident doctors knew oral, IM and IV routes for analgesic therapy. The most common side effect of opioid analgesia listed was addiction. To the question of unrelieved pain, only 2 residents treated the patient appropriately. Conclusion: It is concluded that the resident's knowledge of cancer pain management id deficient and that the College should adopt a workshop approach to cancer pain management. KEY WORDS: Cancer pain management, Resident staff [Nig J Clinical Practice Vol.5(1) 2002: 10-13