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pISSN 2005-9159
eISSN 2093-0569

Clinical Research Article

Korean J Pain 2022; 35(4): 475-487

Published online October 1, 2022 https://doi.org/10.3344/kjp.2022.35.4.475

Copyright © The Korean Pain Society.

Actual situation and prescribing patterns of opioids by pain physicians in South Korea

Min Jung Kim1 , Ji Yeon Kim1 , Yun Hee Lim2 , Sung Jun Hong3 , Jae Hun Jeong4 , Hey Ran Choi5 , Sun Kyung Park6 , Jung Eun Kim7 , Min Ki Lee1 , Jae Hun Kim1

1Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
2Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
3Department of Anesthesiology and Pain Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
4Department of Anesthesiology and Pain Medicine, Jeong-clinic, Seoul, Korea
5Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
6Department of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju, Korea
7Department of Anesthesiology and Pain Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea

Correspondence to:Jae Hun Kim
Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea
Tel: +82-2-2030-5749
Fax: +82-2-2030-5449
E-mail: painfree@kuh.ac.kr

Handling Editor: Sang Wook Shin

Author contributions: Min Jung Kim: Writing/manuscript preparation; Ji Yeon Kim: Investigation; Yun Hee Lim: Investigation; Sung Jun Hong: Investigation; Jae Hun Jeong: Investigation; Hey Ran Choi: Investigation; Sun Kyung Park: Investigation; Jung Eun Kim: Investigation; Min Ki Lee: Investigation; Jae Hun Kim: Supervision.

Received: June 9, 2022; Revised: August 10, 2022; Accepted: September 2, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients’ quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians’ experiences with opioid use in South Korea.
Methods: Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions.
Results: A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks. Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%).
Conclusions: The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.

Keywords: Analgesics, Opioid, Breakthrough Pain, Chronic Pain, Opioid-Related Disorders, Pain, Intractable, Pain Management, Physicians, Prescriptions, Prevalence, Surveys and Questionnaires.