Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, JB Winsløwsvej 19, 2, DK-5000, Odense, Denmark.
Eur J Clin Pharmacol. 2021 Apr;77(4):617-624. doi: 10.1007/s00228-020-03016-6. Epub 2020 Oct 28.
To describe the use of tramadol and other analgesics in Denmark focusing on the impact of media attention (June and December 2017) and regulatory actions (September 2017 and January 2018) on the use of tramadol.
Using nationwide registries, we identified all adults who filled a prescription for tramadol and other analgesics from 2014 to 2019. We described incidence rates, prevalence proportions, and total use of tramadol and other analgesics over time. We also described switching between analgesics, treatment duration, skewness in drug use, and doctor-shopping.
From early 2017 until the end of 2019, total tramadol use decreased markedly while the use of morphine and oxycodone decreased slightly. The quarterly prevalence of tramadol use decreased from 32/1000 individuals in 2014 to 18/1000 at the end of 2019, dropping mainly at the time of media attention. Concomitantly, the quarterly prevalence increased for oxycodone (from 5.1 to 8.2) and morphine (from 8.5 to 9.8), mainly due to more short-term and sporadic users, and decreased for codeine (14 to 9.6). From 2014 to mid-2017, the incidence of tramadol use was stable (around 2.2/1000 person-months) but dropped in June 2017 to 1.7/1000, coinciding with the media attention. The incidence of tramadol use continued to decrease (to 1.1/1000 at the end of 2019).
We identified a decline in tramadol use coinciding with the media attention in 2017 and continuing during regulatory actions. There was generally no evidence of unintended effects on the utilization of opioids related to the media attention and regulatory actions.
描述丹麦曲马多和其他镇痛药的使用情况，重点关注媒体关注（2017 年 6 月和 12 月）和监管行动（2017 年 9 月和 2018 年 1 月）对曲马多使用的影响。
使用全国性登记处，我们确定了 2014 年至 2019 年期间所有开具曲马多和其他镇痛药处方的成年人。我们描述了随时间推移曲马多和其他镇痛药的发生率、流行率和总使用量。我们还描述了镇痛药之间的转换、治疗持续时间、药物使用的偏度和医生购物。
从 2017 年初到 2019 年底，曲马多的总使用量明显下降，而吗啡和羟考酮的使用量略有下降。2014 年每季度曲马多的使用率为 32/1000 人，到 2019 年底降至 18/1000，主要下降发生在媒体关注期间。同时，羟考酮（从 5.1 到 8.2）和吗啡（从 8.5 到 9.8）的每季度流行率增加，主要是由于更多的短期和零星使用者，而可待因（从 14 到 9.6）减少。从 2014 年到 2017 年年中，曲马多的使用率保持稳定（约 2.2/1000 人-月），但 2017 年 6 月降至 1.7/1000，与媒体关注相吻合。曲马多的使用率继续下降（到 2019 年底降至 1.1/1000）。
我们发现，2017 年媒体关注期间以及监管行动期间，曲马多的使用量下降。媒体关注和监管行动一般不会对与媒体关注和监管行动相关的阿片类药物的利用产生意外影响。
