Centre d'addictovigilance, Service de pharmacologie médicale, CHU Bordeaux, Bordeaux, France.
Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team, Pharmacoepidemiology, Bordeaux, France.
Br J Clin Pharmacol. 2021 Feb;87(2):555-564. doi: 10.1111/bcp.14415. Epub 2020 Jul 6.
Analgesics are the most widely used medicines worldwide. In parallel, opioid abuse has increased and is of major concern. The accessibility of pharmacologically powerful medicines and the addictovigilance signals in France about the risk of opiates addiction call for an overview of analgesic use. The objective of this study was to investigate the use of analgesics reimbursed in France over a 10-year period through its prevalence.
A cross-sectional study repeated yearly was conducted by using data from the French reimbursement database from 2006 to 2015. Analgesics were classified according to their pharmacological potency: prevalence of use for each category and sociodemographic characteristics of patients treated were analysed.
The annual prevalence of analgesic use was high and increased during the study period (59.8%, 253 976 users in 2015). In 2015, prevalence was always higher in women and increased with age, except for those older than 84 years. Peripheral analgesics were the most used (55.3%, 234 739 users). The prevalence of weak analgesic use decreased (21.3%, 90 257 users), mainly due to the definitive withdrawal of dextropropoxyphene in France in 2011, which was not offset by an increase in the consumption of other weak analgesics. For strong analgesics (1.2%, 5129 users), morphine was the most widely used, with a dramatic increase in oxycodone use, especially in the elderly.
The prevalence of analgesic use is high: approximately 31 million adults had at least 1 analgesic reimbursed in 2015. The most widely used analgesics were peripheral analgesics, far ahead of opioid analgesics.
镇痛药是全球应用最广泛的药物。与此同时，阿片类药物滥用的情况也在增加，这引起了极大的关注。鉴于药理学强效药物的可及性以及法国关于阿片类药物成瘾风险的药物警戒信号，有必要对镇痛药的使用情况进行全面评估。本研究的目的是通过流行率调查，研究法国在 10 年间使用镇痛药的情况。
本研究采用法国 2006 年至 2015 年的报销数据库数据，进行了一项每年重复的横断面研究。根据药物的药理学强度对镇痛药进行分类：分析每个类别的使用流行率以及接受治疗的患者的社会人口学特征。
镇痛药的年使用流行率较高，并在研究期间有所增加（2015 年为 59.8%，253976 名使用者）。2015 年，女性的使用率始终高于男性，且随年龄增长而增加，但 84 岁以上人群除外。外周镇痛药的使用最为广泛（55.3%，234739 名使用者）。弱阿片类镇痛药的使用流行率下降（21.3%，90257 名使用者），这主要是由于 2011 年法国永久性停用了右丙氧芬，而其他弱阿片类镇痛药的使用量并未增加，故无法弥补这一损失。对于强效镇痛药（1.2%，5129 名使用者），吗啡的使用最为广泛，而羟考酮的使用则急剧增加，尤其是在老年人中。
镇痛药的使用流行率较高：2015 年，约有 3100 万成年人至少有一种镇痛药得到报销。使用最广泛的镇痛药是外周镇痛药，远远领先于阿片类镇痛药。
