A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom
Purpose This study aimed to develop hypotheses to explain the increasing tramadol utilisation, evaluate the impact of tramadol classification, and explore the trend between tramadol utilisation and related deaths in the United Kingdom. Methods This cross-sectional study used individual patien...
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| Format: | Article |
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Wiley
2018
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| Online Access: | https://eprints.nottingham.ac.uk/48450/ |
| _version_ | 1848797765817073664 |
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| author | Chen, Teng-Chou Chen, Li-Chia Knaggs, Roger David |
| author_facet | Chen, Teng-Chou Chen, Li-Chia Knaggs, Roger David |
| author_sort | Chen, Teng-Chou |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Purpose
This study aimed to develop hypotheses to explain the increasing tramadol utilisation, evaluate the impact of tramadol classification, and explore the trend between tramadol utilisation and related deaths in the United Kingdom.
Methods
This cross-sectional study used individual patient data, the Clinical Practice Research Datalink from 1993 to 2015, to calculate monthly defined daily dose (DDD)/1000 registrants, monthly prevalence and incidence of tramadol users, annual supply days, and mean daily dose of tramadol. Aggregated-level national statistics and reimbursement data from 2004 to 2015 were also used to quantify annual and monthly tramadol DDD/1000 inhabitants and rate of tramadol-related deaths in England and Wales. Interrupted time-series analysis was used to evaluate the impact of tramadol classification in June 2014.
Results
Prevalence of tramadol users increased from 23 to 97.6/10 000 registrants from 2000 to 2015. Both annual dose and annual supply days of existing tramadol users were higher than new users. Level and trend of monthly utilisation (β2: −12.9, β3: −1.6) and prevalence of tramadol users (β2: −6.4, β3: −0.37) significantly reduced after classification. Both annual tramadol utilisation and rate of tramadol-related deaths increased before tramadol classification and decreased thereafter.
Conclusions
Increasing tramadol utilisation was influenced by the increase in prevalence and incidence of tramadol users, mean daily dose, and day of supply. Prevalence of tramadol users, tramadol utilisation, and reported deaths declined after tramadol classification. Future studies need to evaluate the influencing factors to ensure the safety of long-term tramadol use. |
| first_indexed | 2025-11-14T20:09:05Z |
| format | Article |
| id | nottingham-48450 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:09:05Z |
| publishDate | 2018 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-484502020-05-04T19:51:12Z https://eprints.nottingham.ac.uk/48450/ A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom Chen, Teng-Chou Chen, Li-Chia Knaggs, Roger David Purpose This study aimed to develop hypotheses to explain the increasing tramadol utilisation, evaluate the impact of tramadol classification, and explore the trend between tramadol utilisation and related deaths in the United Kingdom. Methods This cross-sectional study used individual patient data, the Clinical Practice Research Datalink from 1993 to 2015, to calculate monthly defined daily dose (DDD)/1000 registrants, monthly prevalence and incidence of tramadol users, annual supply days, and mean daily dose of tramadol. Aggregated-level national statistics and reimbursement data from 2004 to 2015 were also used to quantify annual and monthly tramadol DDD/1000 inhabitants and rate of tramadol-related deaths in England and Wales. Interrupted time-series analysis was used to evaluate the impact of tramadol classification in June 2014. Results Prevalence of tramadol users increased from 23 to 97.6/10 000 registrants from 2000 to 2015. Both annual dose and annual supply days of existing tramadol users were higher than new users. Level and trend of monthly utilisation (β2: −12.9, β3: −1.6) and prevalence of tramadol users (β2: −6.4, β3: −0.37) significantly reduced after classification. Both annual tramadol utilisation and rate of tramadol-related deaths increased before tramadol classification and decreased thereafter. Conclusions Increasing tramadol utilisation was influenced by the increase in prevalence and incidence of tramadol users, mean daily dose, and day of supply. Prevalence of tramadol users, tramadol utilisation, and reported deaths declined after tramadol classification. Future studies need to evaluate the influencing factors to ensure the safety of long-term tramadol use. Wiley 2018-05 Article PeerReviewed Chen, Teng-Chou, Chen, Li-Chia and Knaggs, Roger David (2018) A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom. Pharmacoepidemiology and Drug Safety, 27 (5). pp. 487-494. ISSN 1099-1557 drug utilisation; interrupted time series analysis; pharmacoepidemiology; tramadol classification; tramadol-related mortality http://onlinelibrary.wiley.com/doi/10.1002/pds.4320/abstract doi:10.1002/pds.4320 doi:10.1002/pds.4320 |
| spellingShingle | drug utilisation; interrupted time series analysis; pharmacoepidemiology; tramadol classification; tramadol-related mortality Chen, Teng-Chou Chen, Li-Chia Knaggs, Roger David A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom |
| title | A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom |
| title_full | A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom |
| title_fullStr | A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom |
| title_full_unstemmed | A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom |
| title_short | A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom |
| title_sort | 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the united kingdom |
| topic | drug utilisation; interrupted time series analysis; pharmacoepidemiology; tramadol classification; tramadol-related mortality |
| url | https://eprints.nottingham.ac.uk/48450/ https://eprints.nottingham.ac.uk/48450/ https://eprints.nottingham.ac.uk/48450/ |