Regulation of Opioid Drugs in Thai Government Hospitals: Thailand National Survey 2012

CONTEXT: Palliative care in Thailand was not well developed in the past. Previous studies showed that the actual prescription of opioids was underutilized in palliative care by physicians compared with the estimated opioid need of patients. However, there were no studies regarding the regulation of opioids in Thailand. AIMS: To provide an up-to-date overview of the role of multidisciplinary teams in the regulation of opioids in Thai government hospitals. SETTINGS AND DESIGN: A questionnaire survey study was conducted from January to April 2012. MATERIALS AND METHODS: The questionnaire was distributed to entire population of government hospitals in Thailand and all private hospitals in Bangkok. There were 975 hospitals, including 93 private hospitals in Bangkok and 882 government hospitals. STATISTICAL ANALYSIS USED: Results are presented as a frequency and percentage. RESULTS: Special opioid prescription forms must be signed by doctors for all opioid prescriptions. Three-fourths of hospitals totally prohibited prescribing oral opioids by palliative care Advance Practice Nurses. Pharmacists were permitted to correct the technical errors on a prescription of oral morphine only after notifying the prescribing doctor in nearly 60% of hospitals. In terminal patients who could not go to the hospitals, caregivers were permitted to collect the opioids on behalf of patients in nearly 80% of hospitals. CONCLUSION: Our results illustrate that the regulation of opioids in government hospitals is mainly dependent on physician judgment. Patients can only receive oral morphine at a hospital pharmacy.