Recognition of tramadol abuse, dispensing practices, and opinions about its control policy among community pharmacists in Bangkok, Thailand
and | Apr 30, 2019
About this article
Article Category: Original article
Published Online: Apr 30, 2019
Page range: 91 - 99
DOI: https://doi.org/10.1515/abm-2019-0006
Keywords
© 2018 Tulaya Potaros, Suwimon Yeephu, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Opinions of pharmacists on tramadol control policy
| Opinion of pharmacists | n (%) |
|---|---|
| Practicability of policy implementation (n = 305) | |
| Practical | 252 (82.6) |
| Not practical | 53 (17.4) |
| Ability of policy to reduce tramadol abuse problem | |
| (n = 305) | |
| Agreed | 131 (43.0) |
| Disagreed | 112 (36.7) |
| Not assured | 62 (20.3) |
| Scenario of rescheduling tramadol as a prescription | |
| medicine (n = 305) | |
| Agreed | 90 (29.5) |
| Disagreed | 184 (60.3) |
| Not assured | 31 (10.2) |
Tramadol dispensing practices
| Tramadol dispensing | Number of pharmacies/pharmacists n (%) |
|---|---|
| Number of customers (cases per week; | |
| n = 83) | |
| <1 | 25 (30) |
| 1–5 | 40 (48) |
| 6–10 | 11 (13) |
| >10 | 7 (8) |
| Number of drugs dispensed | |
| (tablets/capsules per patient; n = 75)‡ | |
| <10 | 4 (5) |
| 10–20 | 69 (92) |
| >20 | 2 (3) |
| Number of customers (cases per week; | |
| n = 136)§ | |
| <1 | 74 (54) |
| 1–5 | 55 (41) |
| 6–10 | 4 (3) |
| >10 | 3 (2) |
| Number of drugs dispensed | |
| (tablets/capsules per patient; n = 113)|| | |
| <10 | 7 (6) |
| 10–20 | 105 (93) |
| >20 | 1 (1) |
| Supplying regular medicine along with | |
| previous prescriptions | 137 (74) |
| Moderate-to-severe pain | 112 (61) |
| Ineffectiveness of other analgesic drugs | 94 (51) |
| Allergy to other analgesic drugs | 56 (30) |
| Precaution/contraindication to other | |
| analgesics, e.g., renal disease and peptic | |
| ulcer | 30 (16) |
| Combining with other analgesics, e.g., | |
| NSAIDs, acetaminophen, and muscle | |
| relaxants | 28 (15) |
| Bone pain | 107 (58) |
| Cancer pain | 78 (42) |
| Back pain | 72 (39) |
| Muscle pain | 56 (30) |
| Tooth pain/pain in oral cavity | 31 (17) |
| Neuropathic pain | 31 (17) |
| Explanation of potential side effect(s) | 155 (84) |
| Explanation of special precaution(s) | 96 (52) |
| Nausea/vomiting | 95 (61) |
| Drowsiness/somnolence | 77 (50) |
| Dizziness | 71 (46) |
| Constipation | 50 (32) |
| Take only as required for pain | 32 (33) |
| Be aware of drug addiction | 25 (26) |
| Avoid long-term use | 18 (19) |
| Be aware of drug interaction | 9 (9) |
Recognition of current tramadol abuse and announcement of the tramadol control policy
| Recognition by pharmacists | n (%) |
|---|---|
| Recognitions (n = 305) Know | 304 (99.7) |
| Do not know | 1 (0.3) |
| Major sources of information (n = 304) | |
| Television news | 150 (49.3) |
| Social media | 135 (44.4) |
| Thai FDA | 112 (36.8) |
| Newspapers | 108 (35.5) |
| Patients/customers | 56 (18.4) |
| Other pharmacists | 45 (14.8) |
| Recognitions (n = 305) | |
| Know | 298 (97.7) |
| Do not know | 7 (2.3) |
| Major sources of information (n = 298) | |
| Thai FDA | 207 (69.5) |
| Social media | 52 (17.5) |
| Head offices of pharmacy chain stores | 33 (11.1) |
| Other pharmacists | 25 (8.4) |
| Television news | 12 (4.0) |
| Faculties of pharmacy | 12 (4.0) |
| The experiences of pharmacists with teenagers asking for tramadol (n = 305) | |
| Yes | 215 (70.5) |
| Number of teenagers (cases per week; n = 213) | |
| <1 | 72 (33.8) |
| 1–5 | 81 (38.0) |
| 6–10 | 29 (13.6) |
| >10 | 31 (14.6) |
| The experiences of pharmacists with customers asking for tramadol > 20 tablets/capsules per case (n = 305) | |
| Yes | 102 (33.4) |
| Number of customers (cases per week; n = 94)‡ | |
| <1 | 70 (75) |
| 1–5 | 19 (20) |
| 6–10 | 2 (2) |
| >10 | 3 (3) |
Demographic data and characteristics of pharmacists and pharmacies
| Characteristics | Values† |
|---|---|
| Female | 190 (62.3) |
| Age: mean ± SD (years) | 36.6 ± 11.5 |
| Full-time pharmacist | 238 (78.0) |
| Work experience in pharmacies: mean ± SD (years) | 8.8 ± 9.3 |
| Stand-alone pharmacies | 216 (70.8) |
| Chain pharmacies | 89 (29.2) |
| Retail pharmacies | 279 (91.5) |
| Both retail and wholesale pharmacies | 26 (8.5) |
| <20 | 20 (6.6) |
| 21–40 | 69 (22.6) |
| 41–60 | 56 (18.4) |
| 61–80 | 47 (15.4) |
| 81–100 | 61 (20.0) |
| >100 | 52 (17.1) |
| <10 | 82 (26.9) |
| 11–20 | 124 (40.7) |
| 21–30 | 48 (15.7) |
| 31–40 | 25 (8.2) |
| 41–50 | 20 (6.6) |
| >50 | 6 (2.0) |
| Yes | 185 (60.7) |
| No | 120 (39.3) |
| Single drug (tramadol) only | 30 (16) |
| Fixed combination drug (tramadol/acetaminophen) only | 97 (52) |
| Both formulations | 58 (31) |