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

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...

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Main Authors: Islam, M., McRae, I., Mazumdar, S., Taplin, S., McKetin, Rebecca
Format: Journal Article
Published: Blackwell Publishing 2016
Online Access:http://hdl.handle.net/20.500.11937/56975
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author Islam, M.
McRae, I.
Mazumdar, S.
Taplin, S.
McKetin, Rebecca
author_facet Islam, M.
McRae, I.
Mazumdar, S.
Taplin, S.
McKetin, Rebecca
author_sort Islam, M.
building Curtin Institutional Repository
collection Online Access
description 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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spelling curtin-20.500.11937-569752018-01-05T07:50:44Z Prescription opioid analgesics for pain management in Australia: 20 years of dispensing Islam, M. McRae, I. Mazumdar, S. Taplin, S. McKetin, Rebecca 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. 2016 Journal Article http://hdl.handle.net/20.500.11937/56975 10.1111/imj.12966 Blackwell Publishing restricted
spellingShingle Islam, M.
McRae, I.
Mazumdar, S.
Taplin, S.
McKetin, Rebecca
Prescription opioid analgesics for pain management in Australia: 20 years of dispensing
title Prescription opioid analgesics for pain management in Australia: 20 years of dispensing
title_full Prescription opioid analgesics for pain management in Australia: 20 years of dispensing
title_fullStr Prescription opioid analgesics for pain management in Australia: 20 years of dispensing
title_full_unstemmed Prescription opioid analgesics for pain management in Australia: 20 years of dispensing
title_short Prescription opioid analgesics for pain management in Australia: 20 years of dispensing
title_sort prescription opioid analgesics for pain management in australia: 20 years of dispensing
url http://hdl.handle.net/20.500.11937/56975