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5PSQ-079 The use of fentanyl sublingual tablets in a hospital
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  1. C Juez,
  2. AC Viney,
  3. E Conesa Nicolas,
  4. S Nuñez Redondo,
  5. A Lloret Llorca,
  6. CN Garcia Matillas,
  7. G Sarrió Montes,
  8. MH Garcia Lagunar,
  9. A Chica Marchal,
  10. MDM Sanchez Catalicio,
  11. MC Gonzalez Perez-Crespo
  1. Hospital Universitario Santa Lucia, Hospital Pharmacy, Cartagena- Murcia, Spain

Abstract

Background Fentanyl sublingual tablets are indicated for the management of breakthrough pain in cancer patients who are already receiving, and tolerant to, around-the-clock opioid therapy for persistent cancer pain.

Purpose To evaluate the use of fentanyl sublingual tablets in our hospital.

Material and methods Retrospective observational study from June 2017 to February 2018 where all hospitalised patients who were receiving sublingual fentanyl tablets were included.

A database was developed in which demographical data (age and sex), service of the prescribing doctor, prescribed doses and indication of sublingual fentanyl were collected.

Results We studied 164 patients in total, 80 (48.78%) were males and 84 (51.22%) were females with a median age of 60.25 years’ old.

Ninety-six (58.54%) were cancer patients of which 79 (82.30%) were patients with breakthrough pain who were already in treatment with other opioids, eight (8.33%) had an established dose without condition of the pain the patient was suffering and nine (9.38%) did not have the prescription in their computerised clinical history.

The most diagnosed cancers in these patients were: 17 lung (17.70%), 11 colon (11.46%), eight pancreas (8.33%) and six mammary gland (6.25%).

The remaining 68 (41.46%) patients were not cancer patients. The most common pains for which sublingual fentanyl was used were: 13 (19.12%) postoperatory pain, 10 (14.71%) rheumatoid pain, six (8.82%) diabetic foot disease, six (8.82%) ischaemias due to a vascular disease, five (7.35%) uncontrolled postpartum pain and four uncontrolled pain after a traumatism. Three (4.41%) of the non-cancer patients used sublingual fentanyl tablets with an established dose without a breakthrough pain.

In total, the prescription of fentanyl sublingual tablets in the computerised clinical history of the patients was not found 18 times (10.98%). The maximun number of tablets were not specified in 55 patients (33.54%).

The most common services that prescribed the medication were: 20 (29.41%) anaesthesia, 12 (17.65%) vascular angiology and 11 (16.18%) rheumatology.

Conclusion There are several patients in treatment with sublingual fentanyl that do not fit in its approved indication in our hospital.

Pharmacists must participate in the development of guidelines to ensure the indication of fentanyl sublingual tablets is correct and to try to decrease the drug dependence related to its uncontrolled use.

References and/or acknowledgements I would like to express my gratitude to my co-workers for helping with this research.

No conflict of interest.

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