The attitudes of patients and health care personnel to rectal drug administration following day case surgery

Abstract

The i.v. route was most popular with young (98% under 20 years) females (79%) social class I subjects The use of suppositories has been examined following (90%), doctors (96%), nurses (95%), those who had a recent case in which an anaesthetist was reported never had a suppository (81%) and those who had ill to the United Kingdom General Medical Council. This effects following a previous suppository (95%). This study examined the preference for routes of adresult suggests that patients are more tolerant of supministration of post-operative analgesia. A semipositories than hospital staff but the majority prefer structured interview with a written questionnaire was the i.v. route. administered to 610 subjects (49 doctors; 62 nurses; 67 paramedical staff; 44 other hospital employees; 388Keywords: analgesia, suppository; intravenous, nonpatients). Four hundred and fifty (74%) preferred the steroidal anti-inflammatory drugs; general anaesintravenous (i.v.) route, 24 (4%) preferred a supthesia. pository while 136 (22%) found either route acceptable.

Parental opinions regarding the route of administration of analgesic medication in children

“…We found that the rectal ROA was the least popular with parents with respect to their children. This view is in accordance with studies of adults’ personal preferences and may reflect the particular attitude of the UK population, since the rectal route is known to be well accepted in some other countries ( 1, 8). Overall, the rectal route was rated as the most unpleasant of all routes and the least preferred, even in comparison with the intramuscular route, by a high proportion of parents.…”

“…This result is in agreement with Colbert et al . who found that patients with successful past experience of suppositories were more tolerant to the idea of having rectal drugs ( 1).…”

“…There are few data regarding prevailing attitudes and opinions of parents or children towards the route of administration (ROA) of analgesics and other medications, although they are likely to influence perceptions of the overall quality of care. A number of studies have investigated the subject in adult patients and health care personnel following adverse pubilicity generated by a high profile legal case concerning the use of a rectal suppository ( 1–3). Recent guidelines from the Royal College of Anaesthetists have recommended that parents attitudes and comments should be sought concerning the quality of care provided by paediatric anaesthetic services ( 4).…”

“…In addition, there is also some controversy surrounding the need for consent before certain ROA are used ( 1–3, 11–13). Recent guidelines published by The Association of Anaesthetists of Great Britain and Ireland recommended informing patients if a technique of a ‘sensitive nature such as insertion of an analgesic suppository is to be employed’, but again particular consideration has not been given to children ( 12).…”

Consent, sectionalisation and the concept of a medical procedure

“…24 Similarly, in another study, 74% of patients preferred the intravenous to the rectal route which they said was "undignified", an "invasion", "embarrassing", and "humiliating"; 7.6% even considered it an "assault". 25 Since these studies were performed for other reasons, however, the support they provide is limited. Thus, further studies are necessary to specifically address some of the relevant issues.…”