Trends in opioid utilisation in Australia, 2006-2015: Insights from multiple metrics
Trends in opioid utilisation in Australia, 2006-2015: Insights from multiple metrics
复制标题
DOI：
10.1002/pds.4369
复制
发表时间：
2018-05-01
影响因子：
2.6
通讯作者：
Pearson, Sallie-Anne
中科院分区：
文献类型：
--
作者：
Karanges, Emily A.;Buckley, Nicholas A.;Pearson, Sallie-Anne
目的：基于人群的观察性研究记录了阿片类镇痛药使用的全球增加。许多研究使用了单一的人群调整指标（分配次数，限定日剂量[DDDs]或口服吗啡当量[OME]）。我们结合联合收割机这些基于量的指标与措施的人数分发阿片类药物，以获得洞察澳大利亚的趋势，在规定的阿片类药物use.Methods：我们获得了记录规定的阿片类药物分配（2006-2015年）根据澳大利亚的医药福利计划补贴。我们使用配药声明来量化使用的年度变化，根据3个基于量的指标：DDD/1000 pop/day，OME/1000 pop/day，和配药/1000 pop。我们使用10%随机抽样的符合药品福利计划的澳大利亚人的数据估计了给定年份中至少分发一种阿片类药物的人数（人）/1000 pop。结果：根据所有指标，总阿片类药物使用量增加，特别是OME/1000流行/天（增加51%）和分发/1000流行（44%）。较弱的阿片类药物使用保持稳定或下降;强烈的阿片类药物使用增加。获得较弱阿片类药物的人数仅下降了31%，仅分配强效阿片类药物的人数增加了238%。强阿片类药物的使用也根据分配/1000流行（140%），OME/1000流行/天（80%）和DDD/1000流行/天（增加71%）而增加。结论：我们的研究结果表明，2006年至2015年期间阿片类药物使用总量的增加主要是由越来越多的人以较低的药物强度/剂量接受强阿片类药物治疗所致。这种方法可以在有或没有个人层面数据的情况下使用，以深入了解随着时间的推移导致药物使用变化的因素。
Purpose: Population-based observational studies have documented global increases in opioid analgesic use. Many studies have used a single population-adjusted metric (number of dispensings, defined daily doses [DDDs], or oral morphine equivalents [OMEs]). We combine these volume-based metrics with a measure of the number of persons dispensed opioids to gain insights into Australian trends in prescribed opioid use.Methods: We obtained records of prescribed opioid dispensings (2006-2015) subsidised under Australia's Pharmaceutical Benefits Scheme. We used dispensing claims to quantify annual changes in use according to 3 volume-based metrics: DDD/1000 pop/day, OME/1000 pop/day, and dispensings/1000 pop. We estimated the number of persons dispensed at least one opioid in a given year (persons)/1000 pop using data from a 10% random sample of Pharmaceutical Benefits Scheme-eligible Australians.Results: Total opioid use increased according to all metrics, especially OME/1000 pop/day (51% increase) and dispensings/1000 pop (44%). Weaker opioid use remained stable or declined; strong opioid use increased. The rate of persons accessing weaker opioids only decreased 31%, and there was a 238% increase in persons dispensed only strong opioids. Strong opioid use also increased according to dispensings/1000 pop (140%), OME/1000 pop/day (80%), and DDD/1000 pop/day (71% increase).Conclusions: Our results suggest that the increases in total opioid use between 2006 and 2015 were predominantly driven by a growing number of people treated with strong opioids at lower medicine strengths/doses. This method can be used with or without person-level data to provide insights into factors driving changes in medicine use over time.