[The use of narcotic analgesics in primary care in Spain (1988-1991). An evaluation of the impact of new technologies in the pharmaceutical sector].
OBJECTIVE
To analyse the results of the policy of encouraging rational use of analgesics in Spain.


METHODS
Longitudinal retrospective and observational study, on the exhaustive information deriving from the filling out of Analgesic Extra-therapeutic Dose notebooks. SITE. Primary Care treatment of terminal oncological patients carried out basically in the Province of Barcelona.


METHODS
All treatments carried out under the extra-therapeutic dose notebook during the last quarter of 1988 and the first quarters of 1989, 1990, and 1991.


RESULTS
Revision of initial treatment, change of medication and posology and returns on the basis of the extensive documentation generated. Consumption has risen from 157 authorized cases in 1989 to 404 in 1991.


CONCLUSIONS
Consumption has increased sharply, although the opinion that such analgesics are under-used still predominates. Along with the quantitative increase there has been a corresponding deterioration in the rationale informing use and control, both medically (patterns of treatment, excesses) and socially (cost effectiveness, fair allocation). The evaluation in force before the advent of new technology and policies should be reinstated if we wish to achieve the desired level of effectiveness, adapting national health care by coordinating social and health care and bringing up to standard the training and supply of information to health workers. It is suggested that a "Consensus" Conference should be organised to bring up to date the basis on which analgesics are used and regulated.
Illa Sendra
J R
JR
Ministerio de Sanidad y Consumo, Servicios Periféricos en Cataluña.
D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004363:Drug Utilization / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008499:Medical Records / Q000706:statistics & numerical data; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013607:Tablets; D013673:Technology Assessment, Biomedical; D013678:Technology, Pharmaceutical
D000701:Analgesics, Opioid; D013607:Tablets
Utilización de analgésicos narcóticos en atención primaria en España (1988-1991). Evaluación del impacto de nuevas tecnologías en el sector farmacéutico.