Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
J Pain. 2013 Dec;14(12):1686-1693.e1. doi: 10.1016/j.jpain.2013.08.012.
The pain medication OxyContin (hereafter referred to as oxycodone extended release) has been the subject of sustained, and largely negative, media attention in recent years. We sought to determine whether media coverage of oxycodone extended release in North American newspapers has led to changes in prescribing of the drug in Nova Scotia, Canada. An interrupted time-series design examined the effect of media attention on physicians' monthly prescribing of opioids. The outcome measures were, for each physician, the monthly proportions of all opioids prescribed and the proportion of strong opioids prescribed that were for oxycodone extended release. The exposure of interest was media attention defined as the number of articles published each month in 27 North American newspapers. Variations in media effects by provider characteristics (specialty, prescribing volume, and region) were assessed. Within-provider changes in the prescribing of oxycodone extended release in Nova Scotia were observed, and they followed changes in media coverage. Oxycodone extended release prescribing rose steadily prior to receiving media attention. Following peak media attention in the United States, the prescribing of oxycodone extended release slowed. Likewise, following peak coverage in Canadian newspapers, the prescribing of oxycodone extended release declined. These patterns were observed across prescriber specialties and by prescriber volume, though the magnitude of change in prescribing varied.
This study demonstrates that print media reporting of oxycodone extended release in North American newspapers, and its continued portrayal as a social problem, coincided with reductions in the prescribing of oxycodone extended release by physicians in Nova Scotia.
近年来,阿片类药物奥施康定(以下简称羟考酮缓释片)一直是媒体持续关注的焦点,且大多是负面报道。我们试图确定北美报纸对羟考酮缓释片的报道是否导致加拿大新斯科舍省(Nova Scotia)医生对该药的处方发生了变化。一项中断时间序列设计研究考察了媒体关注度对医生每月开具阿片类药物处方的影响。我们的研究结果是,对于每位医生,每月开具的所有阿片类药物的比例以及开具的强阿片类药物中羟考酮缓释片的比例。感兴趣的暴露因素是媒体关注度,定义为北美 27 家报纸每月发表的文章数量。评估了提供者特征(专业、处方量和地区)对媒体效果的影响。在新斯科舍省观察到医生开具羟考酮缓释片的处方有变化,且这些变化与媒体报道有关。在媒体关注之前,羟考酮缓释片的处方量稳步上升。在美国媒体关注度达到高峰后,羟考酮缓释片的处方量增速放缓。同样,在加拿大报纸的报道达到高峰后,羟考酮缓释片的处方量也下降了。这些模式在医生的专业和处方量上都有观察到,尽管处方量的变化幅度有所不同。
这项研究表明,北美报纸对羟考酮缓释片的报道,以及媒体持续将其描绘为社会问题,与新斯科舍省医生开具羟考酮缓释片的处方减少相吻合。