Smolina Kate, Gladstone Emilie, Morgan Steven G
UBC School of Population and Public Health, Vancouver, BC, Canada.
Pharmacoepidemiol Drug Saf. 2016 May;25(5):553-9. doi: 10.1002/pds.3989. Epub 2016 Mar 7.
To explore the determinants of total opioid consumption in a Canadian province, and to examine patterns of opioid dispensations by sex, age, and income quintile.
We used population-based administrative data on prescription drug dispensations in British Columbia (BC; population ~4 million). We apply an index-based approach to examine how changes in population exposure, type of opioids used, and intensity of use contributed to changes in total morphine equivalents dispensed per 1000 population.
Between 2005 and 2013 in BC, opioid consumption increased by 31%, driven by longer duration of opioid therapy and by an increase in the use of stronger opioids. Consumption increased for oxycodone, hydromorphone, fentanyl, and tramadol; and declined for morphine, codeine, and other opioids. While we did not find large sex and age differences, the total level of opioid consumption was three times as high among individuals in the lowest income quintile compared to those in the highest income quintile.
Our findings on changes in the type of opioids used and changes in intensity of use suggest that modifications to clinical management of patients on opioid therapy may be warranted. Similar drug utilization statistics, derived from drug information systems, can be reproduced in other jurisdictions to enable a better understanding of the opioid crisis. Copyright © 2016 John Wiley & Sons, Ltd.
探究加拿大一个省份阿片类药物总消费量的决定因素，并按性别、年龄和收入五分位数研究阿片类药物的配药模式。
我们使用了不列颠哥伦比亚省（BC；人口约400万）基于人群的处方药配药行政数据。我们采用基于指数的方法来研究人群暴露、所用阿片类药物类型和使用强度的变化如何导致每1000人口中吗啡当量总配药量的变化。
2005年至2013年期间，BC省的阿片类药物消费量增加了31%，这是由阿片类药物治疗时间延长以及更强效阿片类药物使用增加所驱动的。羟考酮、氢吗啡酮、芬太尼和曲马多的消费量增加；而吗啡、可待因和其他阿片类药物的消费量下降。虽然我们没有发现明显的性别和年龄差异，但最低收入五分位数人群的阿片类药物总消费量是最高收入五分位数人群的三倍。
我们关于所用阿片类药物类型变化和使用强度变化的研究结果表明，可能有必要对接受阿片类药物治疗的患者的临床管理进行调整。源自药物信息系统的类似药物利用统计数据可在其他司法管辖区重现，以便更好地了解阿片类药物危机。版权所有© 2016约翰·威利父子有限公司。
