Gomes Tara, Mamdani Muhammad M, Paterson J Michael, Dhalla Irfan A, Juurlink David N
Scientist at the Institute for Clinical Evaluative Sciences; Assistant Professor at the Institute for Health Policy, Management and Evaluation and the Leslie Dan Faculty of Pharmacy at the University of Toronto; and Scientist at the Li Ka Shing Knowledge Institute at St Michael's Hospital in Toronto, Ont.
Scientist at the Institute for Clinical Evaluative Sciences; Professor at the Institute for Health Policy, Management and Evaluation, the Department of Medicine, and the Leslie Dan Faculty of Pharmacy at the University of Toronto; and Scientist at the Li Ka Shing Knowledge Institute and the Department of Medicine at St Michael's Hospital.
Can Fam Physician. 2014 Sep;60(9):826-32.
To describe trends in rates of prescribing of high-dose opioid formulations and variations in opioid product selection across Canada.
Population-based, cross-sectional study.
Canada.
Retail pharmacies dispensing opioids between January 1, 2006, and December 31, 2011.
Opioid dispensing rates, reported as the number of units dispensed per 1000 population, stratified by province and opioid type.
The rate of dispensing high-dose opioid formulations increased 23.0%, from 781 units per 1000 population in 2006 to 961 units per 1000 population in 2011. Although these rates remained relatively stable in Alberta (6.3% increase) and British Columbia (8.4% increase), rates in Newfoundland and Labrador (84.7% increase) and Saskatchewan (54.0% increase) rose substantially. Ontario exhibited the highest annual rate of high-dose oxycodone and fentanyl dispensing (756 tablets and 112 patches per 1000 population, respectively), while Alberta's rate of high-dose morphine dispensing was the highest in Canada (347 units per 1000 population). Two of the highest rates of high-dose hydromorphone dispensing were found in Saskatchewan and Nova Scotia (258 and 369 units per 1000 population, respectively). Conversely, Quebec had the lowest rate of high-dose oxycodone and morphine dispensing (98 and 53 units per 1000 population, respectively).
We found marked interprovincial variation in the dispensing of high-dose opioid formulations in Canada, emphasizing the need to understand the reasons for these differences, and to consider developing a national strategy to address opioid prescribing.
描述加拿大高剂量阿片类药物制剂的处方率趋势以及阿片类产品选择的差异。
基于人群的横断面研究。
加拿大。
2006年1月1日至2011年12月31日期间配发阿片类药物的零售药店。
阿片类药物配药率，按省份和阿片类药物类型分层，以每1000人口配发的单位数表示。
高剂量阿片类药物制剂的配药率增长了23.0%，从2006年每1000人口781单位增至2011年每1000人口961单位。尽管艾伯塔省（增长6.3%）和不列颠哥伦比亚省（增长8.4%）的这些比率相对稳定，但纽芬兰与拉布拉多省（增长84.7%）和萨斯喀彻温省（增长54.0%）的比率大幅上升。安大略省高剂量羟考酮和芬太尼的年配药率最高（分别为每1000人口756片和112贴），而艾伯塔省高剂量吗啡的配药率在加拿大最高（每1000人口347单位）。萨斯喀彻温省和新斯科舍省的高剂量氢吗啡酮配药率位居前列（分别为每1000人口258和369单位）。相反，魁北克省高剂量羟考酮和吗啡的配药率最低（分别为每1000人口98和53单位）。
我们发现加拿大高剂量阿片类药物制剂的配药存在显著的省际差异，这凸显了了解这些差异原因并考虑制定全国性阿片类药物处方应对策略的必要性。
