Prescription opioid analgesics for pain management in Australia: 20 years of dispensing.

Islam, MM; McRae, IS; Mazumdar, S; Taplin, S; McKetin, R

Prescription opioid analgesics for pain management in Australia: 20 years of dispensing.

Islam, MM McRae, IS Mazumdar, S Taplin, S

McKetin, R

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Intern Med J, 2016, 46, (8), pp. 955-963
Issue Date:: 2016-08

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Field	Value	Language
dc.contributor.author	Islam, MM
dc.contributor.author	McRae, IS
dc.contributor.author	Mazumdar, S
dc.contributor.author	Taplin, S https://orcid.org/0000-0001-8752-009X
dc.contributor.author	McKetin, R
dc.date.accessioned	2022-08-20T07:25:11Z
dc.date.available	2015-11-08
dc.date.available	2022-08-20T07:25:11Z
dc.date.issued	2016-08
dc.identifier.citation	Intern Med J, 2016, 46, (8), pp. 955-963
dc.identifier.issn	1444-0903
dc.identifier.issn	1445-5994
dc.identifier.uri	http://hdl.handle.net/10453/160555
dc.description.abstract	BACKGROUND: Opioid prescribing/dispensing data can inform policy surrounding regulation by informing trends and types of opioid prescribed and geographic variations. In Australia so far only partial data on dispensing have been published, and data for states/territories remain unknown. AIM: Using a range of measures, this study examines 20-year (1992-2011) trends in prescription opioid analgesics in Australia - both nationally and for individual jurisdictions. METHODS: Dispensing data were obtained from the Drug Utilisation Sub-Committee and the Pharmaceutical Benefits Scheme (PBS) websites. Trends in numbers of prescriptions and daily defined dose (DDD)/1000 people/day were examined over time and across states/territories. Seasonal variations in PBS/Repatriation Pharmaceutical Benefits Scheme (RPBS) items for nationwide dispensing were adjusted using a centred moving smoothing technique. RESULTS: In two decades, 165.32 million prescriptions for opioids were dispensed, with codeine and its derivatives the most prescribed formulation (50.1%) followed by tramadol (13.5%) and oxycodone derivatives (12.7%). In terms of DDD/1000 people/day, dispensing increased from 5.38 in 1992 to 14.46 in 2011. There are significant increasing trends for total, PBS/RPBS and under co-payment prescriptions (priced below patient co-payment). The DDD/1000 people/day for items dispensed through PBS/RPBS was highest in Tasmania. CONCLUSION: Prescription opioid dispensing increased substantially over the study period. With an ageing population, this trend is likely to continue in future. A growing concern about harms associated with opioid use warrants balanced control measures so that harms could be minimised without reducing effective pain treatment. Research examining utilisation in small geographic areas may help design spatially tailored interventions. A real-time drug-monitoring programme may reduce undue prescribing and dispensing.
dc.format	Print
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Intern Med J
dc.relation.isbasedon	10.1111/imj.12966
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences, 1117 Public Health and Health Services
dc.subject.classification	General & Internal Medicine
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Australia
dc.subject.mesh	Drug Prescriptions
dc.subject.mesh	Drug Utilization
dc.subject.mesh	Humans
dc.subject.mesh	Pain
dc.subject.mesh	Pain Management
dc.subject.mesh	Practice Patterns, Physicians'
dc.subject.mesh	Humans
dc.subject.mesh	Pain
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Drug Utilization
dc.subject.mesh	Australia
dc.subject.mesh	Drug Prescriptions
dc.subject.mesh	Pain Management
dc.subject.mesh	Practice Patterns, Physicians'
dc.title	Prescription opioid analgesics for pain management in Australia: 20 years of dispensing.
dc.type	Journal Article
utslib.citation.volume	46
utslib.location.activity	Australia
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2022-08-20T07:25:09Z
pubs.issue	8
pubs.publication-status	Published
pubs.volume	46
utslib.citation.issue	8

Abstract:

BACKGROUND: Opioid prescribing/dispensing data can inform policy surrounding regulation by informing trends and types of opioid prescribed and geographic variations. In Australia so far only partial data on dispensing have been published, and data for states/territories remain unknown. AIM: Using a range of measures, this study examines 20-year (1992-2011) trends in prescription opioid analgesics in Australia - both nationally and for individual jurisdictions. METHODS: Dispensing data were obtained from the Drug Utilisation Sub-Committee and the Pharmaceutical Benefits Scheme (PBS) websites. Trends in numbers of prescriptions and daily defined dose (DDD)/1000 people/day were examined over time and across states/territories. Seasonal variations in PBS/Repatriation Pharmaceutical Benefits Scheme (RPBS) items for nationwide dispensing were adjusted using a centred moving smoothing technique. RESULTS: In two decades, 165.32 million prescriptions for opioids were dispensed, with codeine and its derivatives the most prescribed formulation (50.1%) followed by tramadol (13.5%) and oxycodone derivatives (12.7%). In terms of DDD/1000 people/day, dispensing increased from 5.38 in 1992 to 14.46 in 2011. There are significant increasing trends for total, PBS/RPBS and under co-payment prescriptions (priced below patient co-payment). The DDD/1000 people/day for items dispensed through PBS/RPBS was highest in Tasmania. CONCLUSION: Prescription opioid dispensing increased substantially over the study period. With an ageing population, this trend is likely to continue in future. A growing concern about harms associated with opioid use warrants balanced control measures so that harms could be minimised without reducing effective pain treatment. Research examining utilisation in small geographic areas may help design spatially tailored interventions. A real-time drug-monitoring programme may reduce undue prescribing and dispensing.

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http://hdl.handle.net/10453/160555