The use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation

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dc.contributor.advisorParker, Romy
dc.contributor.advisorFlint, Margot
dc.contributor.authorMuissa, Mbombo Marie Astrid
dc.date.accessioned2026-01-13T07:19:59Z
dc.date.available2026-01-13T07:19:59Z
dc.date.issued2025
dc.date.updated2026-01-12T08:25:45Z
dc.description.abstractBackground: The use of tramadol in the management of chronic pain has recently become controversial. Amidst rising reports on potential for abuse and its exclusion from latest international guidelines, the conduct of a Medicine Usage Evaluation (MUE) of the drug is relevant to inform future training and practice. Methods: A cross sectional retrospective descriptive chart review of the use of tramadol for the year 2021 was conducted at the Groote Schuur Chronic Pain Management Clinic (CPMC). A total of 104 folders were reviewed. Descriptive statistics summarise the data. Results: The average person with chronic pain who was being prescribed tramadol included in this MUE was female, receiving a disability grant and in their late fifties (57.28y ±12.32). A median of three comorbidities (IQR 4) were recorded in the folders. The median duration of clinic attendance was 10,5 years (IQR 11,5). Chronic spinal pain (61%) was the most common diagnosis. Atypical tramadol dosages were recorded. Only 4% of patients attributed improvement of their pain to tramadol therapy. Good prescription practices were adhered to for the majority of criteria, the key domains with shortcomings were in documentation of the severity of pain, documentation of assessment for potential drug interactions, and documentation of referral for non-pharmacological treatments. Conclusion: The MUE on the use of tramadol at the Groote Schuur CPMC was characterised by good prescription practices with regard to documentation on patient profile, pain diagnosis and management. We recommend the use of standardised protocols for follow up visits and moving to electronic records. The lack of improvement associated with tramadol therapy reported by patients was concerning. In such circumstances, we support the use of a patient-centred tapering strategy with atypical dosages not exceeding the maximum recommended daily dose and the integration of non-pharmacological treatments.
dc.identifier.apacitationMuissa, M. M. A. (2025). <i>The use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/42548en_ZA
dc.identifier.chicagocitationMuissa, Mbombo Marie Astrid. <i>"The use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2025. http://hdl.handle.net/11427/42548en_ZA
dc.identifier.citationMuissa, M.M.A. 2025. The use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation. . University of Cape Town ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/42548en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Muissa, Mbombo Marie Astrid AB - Background: The use of tramadol in the management of chronic pain has recently become controversial. Amidst rising reports on potential for abuse and its exclusion from latest international guidelines, the conduct of a Medicine Usage Evaluation (MUE) of the drug is relevant to inform future training and practice. Methods: A cross sectional retrospective descriptive chart review of the use of tramadol for the year 2021 was conducted at the Groote Schuur Chronic Pain Management Clinic (CPMC). A total of 104 folders were reviewed. Descriptive statistics summarise the data. Results: The average person with chronic pain who was being prescribed tramadol included in this MUE was female, receiving a disability grant and in their late fifties (57.28y ±12.32). A median of three comorbidities (IQR 4) were recorded in the folders. The median duration of clinic attendance was 10,5 years (IQR 11,5). Chronic spinal pain (61%) was the most common diagnosis. Atypical tramadol dosages were recorded. Only 4% of patients attributed improvement of their pain to tramadol therapy. Good prescription practices were adhered to for the majority of criteria, the key domains with shortcomings were in documentation of the severity of pain, documentation of assessment for potential drug interactions, and documentation of referral for non-pharmacological treatments. Conclusion: The MUE on the use of tramadol at the Groote Schuur CPMC was characterised by good prescription practices with regard to documentation on patient profile, pain diagnosis and management. We recommend the use of standardised protocols for follow up visits and moving to electronic records. The lack of improvement associated with tramadol therapy reported by patients was concerning. In such circumstances, we support the use of a patient-centred tapering strategy with atypical dosages not exceeding the maximum recommended daily dose and the integration of non-pharmacological treatments. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Groote Schuur KW - Pain management clinic LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - The use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation TI - The use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation UR - http://hdl.handle.net/11427/42548 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42548
dc.identifier.vancouvercitationMuissa MMA. The use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation. []. University of Cape Town ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42548en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Anaesthesia and Perioperative Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectGroote Schuur
dc.subjectPain management clinic
dc.titleThe use of tramadol at the Groote Schuur chronic pain management clinic (CPMC): a medicine usage evaluation
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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