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An audit of morphine prescribing in a hospice

S H Neo1, E C Loh, W H Koo

  • 1Dover Park Hospice, Singapore.

Singapore Medical Journal
|January 29, 2002
PubMed
Abstract

Insights

This hospice audit revealed significant issues in morphine prescribing, with many patients not receiving optimal pain management. Implementing European guidelines and education could improve morphine use in palliative care.

Area of Science:

  • Palliative Care
  • Pain Management
  • Pharmacology

Background:

  • Morphine is a cornerstone in palliative care for managing moderate to severe pain.
  • Optimizing morphine prescribing is crucial for patient comfort and quality of life in hospice settings.

Purpose of the Study:

  • To audit and analyze morphine prescribing patterns within a hospice environment.
  • To identify deviations from established guidelines in clinical practice.

Main Methods:

  • Retrospective review of 358 patient medical charts.
  • Comparison of current prescribing practices against a standard guideline.

Main Results:

  • 35% of patients were prescribed morphine, with identified deficiencies in dosing and management.
  • Common issues included inadequate breakthrough dosing, inappropriate use for chronic pain, lack of follow-up, and missed nighttime dosing.
  • Prophylactic medications like laxatives and anti-emetics were frequently omitted.

Conclusions:

  • Significant variation and inappropriate morphine prescribing exist in palliative care institutions.
  • Adherence to European guidelines and targeted education may enhance prescribing habits.
  • Future studies are needed to validate and potentially adapt guidelines for local populations.

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