[Prescription of morphinics in the management of pain in Dakar teaching hospitals].
The correct management of pain is one of the most frequent problems in a daily medical practice. To achieve this goal physicians have to use many drugs. Among these drugs morphinics represent a special category with specific rules of administration. To assess the use of morphinics in the management of pain in Dakar teaching hospitals and to determine the reasons of under or over prescription, we carried out this study A questionnaire was sent to 200 medical doctors in two teaching hospitals in Dakar between February and April 1999. The response rate was 89.5% (179). According to 73.2% of medical doctors who answered the questionnaire, pain frequently leads to consultation but surprisingly only 14 physicians (7.8%) recognize a regular use of morphinics while 70.1% of them prescribe morphinics exceptionally Morphinics are mainly used to control pain in cancerology (37.2%) and post-operative pain (21.3%). The main reasons to explain the under-use of morphinics were: the fear of respiratory side-effects of morphinics (35.3%), the ignorance of prescription rules (23.5%). The training regarding prescription of morphinics was provided during medical studies and only 10 out of the medical doctors had an adequate postgraduate training in this domain. As expected 51.4% of physicians thought that their training during medical studies was inadequate. To improve the management of pain in our country we recommend a better training of medical doctors during medical studies and the promotion of postgraduate seminars on the use of these molecules. The legislation and rules of administration must be cleared and these drugs should be more available in drugstores and hospital pharmacies. All of these modifications are necessary to help medical doctors to overcome the fear of morphinics for a better management of pain in our country.
Pouye
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A
Clinique médicale I CHU A. Le Dantec, Avenue Pasteur, Dakar, Sénégal. apouye@refer.sn
Dia
D
D
Sow
P S
PS
Yacouba
H
H
Ndour
C T
CT
Soumare
M
M
Ciss
M
M
Moreira Diop
T
T
D000328:Adult; D000368:Aged; D000698:Analgesia; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004501:Education, Medical; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009022:Morphine Derivatives / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D010820:Physicians; D012675:Senegal; D011795:Surveys and Questionnaires
D009022:Morphine Derivatives