School of Pharmacy, The University of Queensland, Woolloongabba QLD 4102, Australia.
Aust N Z J Public Health. 2013 Apr;37(2):132-8. doi: 10.1111/1753-6405.12030.
There has been increased use of prescription opioid analgesics in Australia in the past 20 years with increasing evidence of related problems. A number of data sources collect information about the dispensed prescribing for opioid medications, but little is known about the extent to which these data sources agree on levels of opioid prescribing.
In Queensland, all opioid prescriptions (S8 prescriptions) dispensed by community pharmacies must be submitted to the Drugs of Dependence Unit (DDU). This potentially comprises a 'gold standard' against which other data sources may be judged. There are two national data sources: the Pharmaceutical Benefits Schedule (PBS) for all medications subsidised by government; and an annual national survey of representative pharmacies, which assesses non-subsidised opioid prescribing. We examined the agreement between these data sources.
The three data sources provided consistent estimates of use over time. The correlations between different data sources were high for most opioid analgesics. There was a substantial (60%) increase in the dispensed use of opioid analgesics and a 180% increase in the dispensed use of oxycodone over the period 2002-2009. Tramadol was the most used opioid-like medication.
Since 2002 different data sources reveal similar trends, namely a substantial increase in the prescribing of opioid medications. With few exceptions, the conclusions derived from using any of these data sources were similar.
Improved access to PBS data for relevant stakeholders could provide an efficient and cost-effective way to monitor use of prescription opioid analgesics.
在过去的 20 年中,澳大利亚处方类阿片类镇痛药的使用有所增加,与之相关的问题也越来越多。有许多数据源收集有关阿片类药物配药的信息,但对于这些数据源在多大程度上对阿片类药物处方水平达成一致,知之甚少。
在昆士兰州,所有社区药房配发的阿片类药物(S8 处方)必须提交给药物依赖股(DDU)。这可能构成了其他数据源可以判断的“黄金标准”。有两个全国性的数据来源:政府补贴的所有药物的药品福利计划(PBS);以及每年对代表性药房进行的非补贴类阿片类药物处方评估的全国性调查。我们检查了这些数据源之间的一致性。
这三个数据源提供了随时间推移的一致使用估计。对于大多数阿片类镇痛药,不同数据源之间的相关性很高。在 2002-2009 年期间,阿片类镇痛药的配发使用量增加了 60%,而奥施康定的配发使用量增加了 180%。曲马多是使用最多的类阿片药物。
自 2002 年以来,不同的数据来源揭示了相似的趋势,即阿片类药物的处方量大幅增加。除了少数例外,使用这些数据源中的任何一个得出的结论都相似。
为相关利益相关者提供更好地获取 PBS 数据的机会,可以为监测处方类阿片类镇痛药的使用提供一种高效且具有成本效益的方法。