Trends and patterns of analgesic utilization in Malaysia from 2010 to 2016: preference for tramadol

Background: Inappropriate or irrational use of analgesics not only leads to increased morbidity and mortality rates and deterioration in quality of life, but can also give rise to misuse of health care resources and increase health care costs. Objectives: To evaluate the trends of analgesics prescribing at outpa- tient tertiary hospital settings and examine the patterns of their utili- zation in NSAIDs, tramadol, and opioid users. Methods: This cross‐sectional study was conducted from 2010‐2016 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, oxyco- done, dihydrocodeine, and buprenorphine) were included in this study

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

Purpose: To examine the trends of analgesic prescribing at public tertiary hospital outpatient settings and explore the patterns of their utilization in 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 v13. Results: A total of 192747 analgesic prescriptions of the nine NSAIDs, tramadol, and five other opioids were prescribed for 97227 patients (51.8% NSAIDs patients, 46.6% tramadol patients, and 1.7% opioid patients) from 2010 to 2016. Tramadol (37.9%, n = 72999) was the most frequently prescribed analgesic followed by ketoprofen (17.5%, n=33793), diclofenac (16.2%, n = 31180), celecoxib (12.2%, n =23487), and other NSAIDs (<4.5%). All the analgesics were increased over time except for meloxicam, indomethacin, and mefenamic acid. Opioids, primarily morphine (2.2%, n = 4021) and oxycodone (0.5%, n = 1049), were prescribed the least but the rate of increase was the highest. Conclusion: Tramadol was the most frequently prescribed analgesic at hospital outpatient settings in Malaysia. Opioids were prescribed the least but noted the highest increase in utilization