Evaluation of Prescribing Practices and Drug Interactions Involving Weak Opioids in Community Pharmacies

Background: The Weak opioids like tramadol and codeine are some of the major prescribed pain relief for moderate pain, but are associated with side effects due to the complex pharmacology related to it, the variation in the CYP2D6 and the interaction among the drugs.Community pharmacists have properly identified and reduced risks.Methods: This is a prospective, cross-sectional study that included a total 70 patients who have received the weak opioid.The study was conducted in the tertiary care setting.3 interviews have been conducted over 14 weeks to investigate the prescription, polypharmacy, drug interactions, adverse effects, and problems with the medicine.Nonparametric tests have been used for the statistical analysis.Results: The pharmacist's interventions have decreased Negative Medication Outcomes (NMOs) in terms of safety and necessity.It also reduced the Drug-Related Problems (DRPs), which included the interactions, the negative events and the non-compliance.The antidepressants, benzodiazepines, or antiepileptics have been observed to enhance the NMOs and DRPs.Constipation, confusion, and falls have been observed as predictors of poor outcomes. Conclusion:The study has concluded that the interventions led by the pharmacist have optimised the opioid therapy and NMOs, DRPs have been decreased and the risk in case of polypharmacy.