Patterns of analgesic prescription and consumption in a university-affiliated community hospital

To assess the patterns of prescription and consumption of analgesic and psychotropic medications, we reviewed the medication records of all 311 adult medical and surgical patients at a university-affiliated community hospital. Acetaminophen combinations and meperidine accounted for 85% of all analgesics prescribed. Analgesic use declined with advancing age. Two or more analgesics were prescribed to 18% of medical patients, compared with 44% in surgical patients. Less than one third of the patients with cancer received analgesics more frequently than every six hours. Nearly all psychotropic prescriptions were for sedative-hypnotics. Our data suggest that (1) physicians prescribe a limited number of analgesics, despite the variety available; (2) elderly patients receive fewer analgesics; (3) polypharmacy occurs often; (4) pain in patients with cancer is probably undertreated; and (5) psychotropic medications are used infrequently for analgesia.