ABSTRACT
Aim: This study aims to evaluate the prescription patterns and side effects of oxycodone in a local hospital setting. Materials and Methods: This is a retrospective analysis of all patients who were prescribed oxycodone for acute or chronic pain from June to November 2007. Patients’ names were obtained from the hospital pharmacy and data were collected with a set of questionnaire after review of their casenotes. Prescription was compared with other recommended opioid prescription guidelines. Side effects to oxycodone use were documented. Results: One hundred and thirty patients were prescribed oxycodone for the 6-month study period. Prescription by the orthopaedic surgeons was the highest, followed by the pain service. Most patients had a clear indication for use of oxycodone and appropriate dosing regimes. However, two thirds of the patients prescribed oxycodone were not reviewed with regard to their analgesia within 24 hours and one third did not have titration of the drug to their pain symptoms. Majority of the patients had outpatient follow-up within 4 weeks of discharge. Common side effects included nausea, vomiting and constipation. Conclusion: This is the first local audit that profiles oxycodone prescription patterns and its side effects. Prescription of oxycodone was appropriate for the majority of the study population. Patient assessment upon initiation of oxycodone therapy and titration of the drug to patients’ pain symptoms was suboptimal. Oxycodone was well tolerated by the study population with minimal side effects. Further quality measures and ongoing education of clinicians will ensure future patients obtain safe and effective analgesia.
Oral opioids have been increasingly used for treatment of both cancer and non-cancer pain.1-4 Oxycodone is a synthetic opioid that has become recently available locally. Elsewhere in the world, its widespread use has been associated with dependence and problematic drug related behaviour.5-8 Appropriate prescription will be essential to avert a similar outcome locally. Apart from a previous audit of morphine use in a hospice here in 2001,9 we believe this is the second local audit of opioid prescription and first audit of oxycodone prescription for our patients. Results of this study will be a strong catalyst for future quality measures regarding oxycodone use.
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