Prevalence and incidence of prescription opioid analgesic use in Australia

Aims The aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics of people with and without cancer initiating prescription opioid analgesics. Methods A retrospective population‐based study was conducte...

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Published in:British journal of clinical pharmacology Vol. 85; no. 1; pp. 202 - 215
Main Authors: Lalic, Samanta, Ilomäki, Jenni, Bell, J. Simon, Korhonen, Maarit Jaana, Gisev, Natasa
Format: Journal Article
Language:English
Published: England John Wiley and Sons Inc 01.01.2019
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ISSN:0306-5251, 1365-2125, 1365-2125
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Abstract Aims The aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics of people with and without cancer initiating prescription opioid analgesics. Methods A retrospective population‐based study was conducted using the random 10% sample of adults who were dispensed prescription opioid analgesics in Australia between July 2013 and June 2017 through the Pharmaceutical Benefits Scheme. Poisson regression was used to calculate rate ratios (RR) for opioid prevalence and incidence. The characteristics of people initiating opioids, including type of opioid initiated, total oral morphine equivalents dispensed, prescriber speciality, medical comorbidities, and past analgesic and benzodiazepine use, were compared for people with and without cancer. Results Opioid prevalence increased {RR = 1.006 [95% confidence interval (CI) 1.004, 1.008]}, while incidence decreased [RR = 0.977 (95% CI 0.975,0.979)] from 2013/2014 to 2016/2017. There were between 287 677 and 307 772 prevalent users each year. In total, 769 334 adults initiated opioids between 2013/2014 and 2016/2017, and half of these initiations were by general practitioners. Initiation with a strong opioid occurred in 55.8% of those with cancer and 28.2% of those without cancer. Conclusion Rates of opioid use have remained high since 2013, with approximately 3 million adults using opioids and over 1.9 million adults initiating opioids each year. Between 2013 and 2017, opioid prevalence has slightly increased but incidence has decreased. People without cancer account for the majority of opioid use and are more likely to be initiated on short‐acting and weak opioids. Initiation of strong opioids has increased over time, reinforcing concerns about increased use and the harms associated with strong opioids in the community.
AbstractList The aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics of people with and without cancer initiating prescription opioid analgesics.AIMSThe aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics of people with and without cancer initiating prescription opioid analgesics.A retrospective population-based study was conducted using the random 10% sample of adults who were dispensed prescription opioid analgesics in Australia between July 2013 and June 2017 through the Pharmaceutical Benefits Scheme. Poisson regression was used to calculate rate ratios (RR) for opioid prevalence and incidence. The characteristics of people initiating opioids, including type of opioid initiated, total oral morphine equivalents dispensed, prescriber speciality, medical comorbidities, and past analgesic and benzodiazepine use, were compared for people with and without cancer.METHODSA retrospective population-based study was conducted using the random 10% sample of adults who were dispensed prescription opioid analgesics in Australia between July 2013 and June 2017 through the Pharmaceutical Benefits Scheme. Poisson regression was used to calculate rate ratios (RR) for opioid prevalence and incidence. The characteristics of people initiating opioids, including type of opioid initiated, total oral morphine equivalents dispensed, prescriber speciality, medical comorbidities, and past analgesic and benzodiazepine use, were compared for people with and without cancer.Opioid prevalence increased {RR = 1.006 [95% confidence interval (CI) 1.004, 1.008]}, while incidence decreased [RR = 0.977 (95% CI 0.975,0.979)] from 2013/2014 to 2016/2017. There were between 287 677 and 307 772 prevalent users each year. In total, 769 334 adults initiated opioids between 2013/2014 and 2016/2017, and half of these initiations were by general practitioners. Initiation with a strong opioid occurred in 55.8% of those with cancer and 28.2% of those without cancer.RESULTSOpioid prevalence increased {RR = 1.006 [95% confidence interval (CI) 1.004, 1.008]}, while incidence decreased [RR = 0.977 (95% CI 0.975,0.979)] from 2013/2014 to 2016/2017. There were between 287 677 and 307 772 prevalent users each year. In total, 769 334 adults initiated opioids between 2013/2014 and 2016/2017, and half of these initiations were by general practitioners. Initiation with a strong opioid occurred in 55.8% of those with cancer and 28.2% of those without cancer.Rates of opioid use have remained high since 2013, with approximately 3 million adults using opioids and over 1.9 million adults initiating opioids each year. Between 2013 and 2017, opioid prevalence has slightly increased but incidence has decreased. People without cancer account for the majority of opioid use and are more likely to be initiated on short-acting and weak opioids. Initiation of strong opioids has increased over time, reinforcing concerns about increased use and the harms associated with strong opioids in the community.CONCLUSIONRates of opioid use have remained high since 2013, with approximately 3 million adults using opioids and over 1.9 million adults initiating opioids each year. Between 2013 and 2017, opioid prevalence has slightly increased but incidence has decreased. People without cancer account for the majority of opioid use and are more likely to be initiated on short-acting and weak opioids. Initiation of strong opioids has increased over time, reinforcing concerns about increased use and the harms associated with strong opioids in the community.
Aims The aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics of people with and without cancer initiating prescription opioid analgesics. Methods A retrospective population‐based study was conducted using the random 10% sample of adults who were dispensed prescription opioid analgesics in Australia between July 2013 and June 2017 through the Pharmaceutical Benefits Scheme. Poisson regression was used to calculate rate ratios (RR) for opioid prevalence and incidence. The characteristics of people initiating opioids, including type of opioid initiated, total oral morphine equivalents dispensed, prescriber speciality, medical comorbidities, and past analgesic and benzodiazepine use, were compared for people with and without cancer. Results Opioid prevalence increased {RR = 1.006 [95% confidence interval (CI) 1.004, 1.008]}, while incidence decreased [RR = 0.977 (95% CI 0.975,0.979)] from 2013/2014 to 2016/2017. There were between 287 677 and 307 772 prevalent users each year. In total, 769 334 adults initiated opioids between 2013/2014 and 2016/2017, and half of these initiations were by general practitioners. Initiation with a strong opioid occurred in 55.8% of those with cancer and 28.2% of those without cancer. Conclusion Rates of opioid use have remained high since 2013, with approximately 3 million adults using opioids and over 1.9 million adults initiating opioids each year. Between 2013 and 2017, opioid prevalence has slightly increased but incidence has decreased. People without cancer account for the majority of opioid use and are more likely to be initiated on short‐acting and weak opioids. Initiation of strong opioids has increased over time, reinforcing concerns about increased use and the harms associated with strong opioids in the community.
The aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics of people with and without cancer initiating prescription opioid analgesics. A retrospective population-based study was conducted using the random 10% sample of adults who were dispensed prescription opioid analgesics in Australia between July 2013 and June 2017 through the Pharmaceutical Benefits Scheme. Poisson regression was used to calculate rate ratios (RR) for opioid prevalence and incidence. The characteristics of people initiating opioids, including type of opioid initiated, total oral morphine equivalents dispensed, prescriber speciality, medical comorbidities, and past analgesic and benzodiazepine use, were compared for people with and without cancer. Opioid prevalence increased {RR = 1.006 [95% confidence interval (CI) 1.004, 1.008]}, while incidence decreased [RR = 0.977 (95% CI 0.975,0.979)] from 2013/2014 to 2016/2017. There were between 287 677 and 307 772 prevalent users each year. In total, 769 334 adults initiated opioids between 2013/2014 and 2016/2017, and half of these initiations were by general practitioners. Initiation with a strong opioid occurred in 55.8% of those with cancer and 28.2% of those without cancer. Rates of opioid use have remained high since 2013, with approximately 3 million adults using opioids and over 1.9 million adults initiating opioids each year. Between 2013 and 2017, opioid prevalence has slightly increased but incidence has decreased. People without cancer account for the majority of opioid use and are more likely to be initiated on short-acting and weak opioids. Initiation of strong opioids has increased over time, reinforcing concerns about increased use and the harms associated with strong opioids in the community.
Author Lalic, Samanta
Gisev, Natasa
Ilomäki, Jenni
Korhonen, Maarit Jaana
Bell, J. Simon
AuthorAffiliation 4 School of Pharmacy and Medical Sciences University of South Australia Adelaide SA Australia
6 National Drug and Alcohol Research Centre, UNSW Sydney Sydney NSW Australia
3 Department of Epidemiology and Preventive Medicine Monash University Melbourne VIC Australia
2 Pharmacy Department Austin Health Melbourne VIC Australia
1 Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical, Sciences Monash University Melbourne VIC Australia
5 Institute of Biomedicine University of Turku Turku Finland
AuthorAffiliation_xml – name: 1 Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical, Sciences Monash University Melbourne VIC Australia
– name: 3 Department of Epidemiology and Preventive Medicine Monash University Melbourne VIC Australia
– name: 6 National Drug and Alcohol Research Centre, UNSW Sydney Sydney NSW Australia
– name: 2 Pharmacy Department Austin Health Melbourne VIC Australia
– name: 5 Institute of Biomedicine University of Turku Turku Finland
– name: 4 School of Pharmacy and Medical Sciences University of South Australia Adelaide SA Australia
Author_xml – sequence: 1
  givenname: Samanta
  orcidid: 0000-0002-7055-3626
  surname: Lalic
  fullname: Lalic, Samanta
  email: samanta.lalic@monash.edu
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  givenname: Jenni
  surname: Ilomäki
  fullname: Ilomäki, Jenni
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  surname: Bell
  fullname: Bell, J. Simon
  organization: University of South Australia
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  givenname: Maarit Jaana
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  givenname: Natasa
  orcidid: 0000-0003-0452-8470
  surname: Gisev
  fullname: Gisev, Natasa
  organization: National Drug and Alcohol Research Centre, UNSW Sydney
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30338545$$D View this record in MEDLINE/PubMed
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Keywords prevalence
pain
opioid analgesics
drug utilization
Australia
incidence
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Snippet Aims The aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the...
The aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics...
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StartPage 202
SubjectTerms Adolescent
Adult
Aged
Analgesics, Opioid - therapeutic use
Australia
Australia - epidemiology
Cancer Pain - drug therapy
Cancer Pain - epidemiology
Comorbidity
Drug Prescriptions - statistics & numerical data
drug utilization
Female
Humans
incidence
Male
Middle Aged
opioid analgesics
Opioid-Related Disorders - prevention & control
Original
pain
Practice Patterns, Physicians' - statistics & numerical data
prevalence
Retrospective Studies
Young Adult
Title Prevalence and incidence of prescription opioid analgesic use in Australia
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fbcp.13792
https://www.ncbi.nlm.nih.gov/pubmed/30338545
https://www.proquest.com/docview/2123725958
https://pubmed.ncbi.nlm.nih.gov/PMC6303244
Volume 85
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