Tramadol prescription patterns for adult patients in the general surgery department over one year period: An institutional-based retrospective study

Abstract

Abstract Introduction: Tramadol pain management is widely used in many clinical settings including per-operative, acute and post-surgical pain management and in obstetrics pain management. However, tramadol use is among other opioids leading to drug-induced morbidity and mortality. There is also a concern that tramadol prescription contributes to tramadol misuse and abuse that increase tramadol intoxication and adverse effects. Objectives: The study aimed to assess tramadol prescription patterns in patients admitted and discharged from the general surgery department of Saint Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, between (January and December 2021). Methods: This is an institutional-based a retrospective chart review study over one year period. Retrospective descriptive. Data collection was done through systematic sampling technique. Results: A total of 380 patients’ charts (224 females) were reviewed. The mean (±,SD) age is 42.25 (±,14.023) years. Tramadol was prescribed to 335 (93.4%) patients, while 25 patients (6.6%) were not prescribed tramadol. Gender is strongly associated with tramadol prescription with a prevalence (OR = 2.52, p= 0. .046) as female patients are twice likely to have tramadol prescribed compared to male patients. Tramadol prescription pattern in 67 (17.6%) patients was as monotherapy while as part of the combinational medications in 288 (75.8%) patients. Diclofenac sodium was the most frequently prescribed medication (in 262 charts or 68.9%) followed by acetaminophen (in 16 charts or 4.2%). The results also showed that tramadol was indicated for post-operative pain (88.7%), abdominal pain (6.3%), genitourinary (1.8%), and back/neck pain (1.6%). Conclusion: Overall, the findings indicate that tramadol prescription is high in the general surgical ward, mostly as part of the combinational medications. Female gender has association with tramadol prescription. Female patients are twice likely to have tramadol prescribed compared to male patients. Furthermore, post-operative pain was the most frequent complaint associated with the prescription of tramadol Keywords: Tramadol, prescription patterns, Ethiopia, general surgery.