Prescription-level of tramadol utilisation at a tertiary hospital setting in Malaysia: changing trends over a 7-year follow-up period

INTRODUCTION It was reported in a previous study that tramadol was the most frequently prescribed analgesic in Malaysia’s hospital outpatient setting. However, little is known of its trends of prescribing. OBJECTIVES This study evaluated the trends of tramadol prescribing in Malaysia. METHOD This retrospective cross-sectional study was conducted using the prescription database of a tertiary hospital in Malaysia. All tramadol prescriptions in outpatient setting issued for adult patients aged ≥18 years old from 2010 to 2016 were included. The annual number of prescriptions and patients measured in repeat cross-sectional estimates for each year were evaluated. Descriptive statistics and linear trend analysis were applied using Stata version 15.1. RESULTS A total of 64594 tramadol prescriptions were prescribed for 40965 patients from 2010 to 2016. Prescriptions for tramadol increased by 52.7% from 7643 in 2010 to 11763 in 2016, with an average annual increment of 7.1%. The number of new patients prescribed with tramadol increased gradually throughout the study period (a 7.2% increase annually) with the majority (75.6%, n=30974) of them receiving one tramadol prescription. CONCLUSION: Tramadol prescribing increased gradually over a 7-year study period, with the majority of patients receiving only one prescription of tramadol - most likely indicating the use of tramadol for acute pain conditions. Further investigation on the indication and its clinical outcomes are required to ensure safe and rational use of tramadol