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12-03-2013 | Pharmacology | Article

Pain management in Taiwan improving, but needs more attention


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medwireNews: Researchers report that opioid prescriptions in Taiwan rose by 55% between 2002 and 2007.

But appropriate use of opioid medication in Taiwan is still lagging behind Europe and North America, add Kwua-Yun Wang (Taipei Veterans General Hospital, Taiwan) and team.

The investigators explain that around 90% of global opioid use occurs in North America and Europe, "although only 20% of the global population lives in these areas. This suggests that opioid consumption is generally insufficient or inadequate in many other countries."

Indeed, the World Health Organization considers opioid consumption to be "an important indicator of a country's progress in cancer pain relief," they add.

By this indicator, the increase in opioid prescriptions observed in Taiwan from 2002 through 2007 implies improvements in the country's management of cancer pain.

Wang and team note that the pattern of change observed in Taiwan cannot be solely attributed to a change in the country's cancer rates because although cancer rates rose over the 6-year period, they did so by only 17%.

During this time, fentanyl prescriptions saw a greater increase than any other opioid, from 188 defined daily dose for statistical purposes (S-DDD) per million inhabitants per day in 2002 to 320 S-DDD per million inhabitants per day in 2007.

Eighty percent of fentanyl, morphine, and codeine prescriptions were given to cancer patients, whereas 80% of pethidine prescriptions went to noncancer patients.

A total of US$ 10.2 million (€ 7.8 million) was spent on opioid prescriptions in Taiwan (population of 23 million) in 2007.

The researchers' observations arise from the analysis of data on prescriptions for fentanyl, morphine, pethidine, and codeine taken from Taiwan's National Health Insurance Research Database for 2002 to 2007.

Writing in the Journal of Pain and Symptom Management, Wang and colleagues attribute Taiwan's currently poor levels of clinical opioid use to a lack of education among doctors, overly restrictive prescription regulations, and cultural prejudices about opioid users.

They conclude that better education on appropriate use of opioids in pain management is required in Taiwan.

By Lauretta Ihonor, medwireNews Reporter

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