title: Opioid consumption in hospitals of the Friuli-Venezia Giulia region: a four-year retrospective study.
abstract: OBJECTIVE
  Opioid consumption for analgesic purposes is considered an important indicator of the quality of cancer pain treatment. Italy's consumption ranks among the lowest in economically developed countries. A lack of systematic education of health care professionals regarding pain control and a sort of "opiophobia" induced by measures designed to control the improper use of drugs have been indicated as possible reasons for this trend. The aim of this study was firstly to evaluate the level of opioid consumption at inpatient institutions (where opioid prescription rules have never been subjected to any restriction) and secondly to survey the attitude of the physicians working in general hospitals and specialized oncology institutions (oncology centers and hospices) towards opioid administration.
  
  
  METHODS
  The authors performed a four-year survey (1996-1999) on the consumption of major opioids (morphine, meperidine, buprenorphine, transdermal fentanyl) among all the inpatient institutions (six regional/provincial hospitals, eleven district hospitals, the Aviano Oncology Institute and two hospices) of the Friuli-Venezia Giulia region in North-Eastern Italy. To facilitate data interpretation, all the opioids were converted to milligrams equivalent of oral morphine (mg OME). Data on the number of days of hospitalization of oncological patients in every institution were also collected.
  
  
  RESULTS
  The overall consumption of opioids was 9,299,177 mg OME (83.3%) and 1,845,060 mg OME (16.7%) in general hospitals and specialized oncology institutions, respectively. Overall, the number of days of hospitalization of oncological patients was 1,121,142 (87%) and 167,665 (13%) in general hospitals and specialized oncology institutions, respectively. The ratio between the total dosage of mg OME administered and the total number of hospitalization days in general hospitals and specialized oncology institutions was 8.29 mg OME/day and 11 mg OME/day, respectively.
  
  
  CONCLUSIONS
  Our data show that in specialized oncology institutions, opioid consumption was proportionally higher than in general hospitals. This result indicates the attitude of the physicians of these institutions towards opioid administration, probably due to the training received on cancer pain treatment, and emphasizes the need to educate all health care workers involved in the management of cancer patients.
authors.affiliation: Unità Operativa Semplice di Terapia del Dolore e Cure Palliative, Centro di Riferimento Oncologico, Aviano, PN, Italy. rbortolussi@cro.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Bortolussi
authors.forename: Simon
authors.initials: S
authors.lastname: Spazzapan
authors.forename: Davide
authors.initials: D
authors.lastname: Lombardi
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Colussi
authors.forename: Andrea
authors.initials: A
authors.lastname: Veronesi
authors.forename: Mira
authors.initials: M
authors.lastname: Matovic
authors.forename: Marcello
authors.initials: M
authors.lastname: De Cicco
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002047:Buprenorphine / Q000008:administration & dosage; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D005283:Fentanyl / Q000008:administration & dosage; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008614:Meperidine / Q000008:administration & dosage; D009020:Morphine / Q000008:administration & dosage; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D013810:Therapeutic Equivalency
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D009020:Morphine; D008614:Meperidine; D005283:Fentanyl