Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James' Hospital, Dublin, Ireland.
Medicines Management Programme, Health Service Executive, St. James' Hospital, Dublin, Ireland.
Pharmacoepidemiol Drug Saf. 2021 Aug;30(8):1003-1011. doi: 10.1002/pds.5247. Epub 2021 May 5.
Significant increases in opioid utilisation have been reported in many countries in recent decades. This study investigated strong opioid prescribing in Irish General Medical Services (GMS) patients over a 10-year period.
A retrospective repeated cross-sectional analysis of a national pharmacy claims database between January 2010 and December 2019 was conducted. Strong opioid prescribing in GMS patients was evaluated, including by route of administration, age (16-64 years and ≥65 years) and gender. Measures of consumption included prescribing prevalence and defined daily dose (DDD)/1000 population/day. Prevalence ratios (PRs) with 95% confidence intervals (CIs), and percentage and absolute changes were determined.
Strong opioid prescribing prevalence increased from 14.43% in 2010 to 16.28% in 2019, with the greatest increase in the ≥65 years age group. Tramadol was the most frequently prescribed product, constituting 63.9% of total strong opioid prescribing. The prescribing prevalence of oxycodone increased from 0.95% in 2010 to 2.68% in 2019 (PR 2.81, 95% CI 2.76, 2.87), with steep increases in oxycodone-naloxone since it became available (PR 5.23, 95% CI 4.98, 5.50). The prescribing prevalence of tapentadol increased from 0.18% to 1.58% between 2012 (first complete year available for reimbursement) and 2019 (PR 8.79, 95% CI 8.43, 9.16). Strong opioid prescribing was highest in females aged ≥65 years.
This study found an overall increase in strong opioid prescribing in Ireland between 2010 and 2019, particularly in older adults. Tramadol was the most frequently prescribed product, with oxycodone and tapentadol prescribing increasing markedly over the study period.
近几十年来，许多国家报告阿片类药物的使用量显著增加。本研究调查了 10 年来爱尔兰普通医疗服务（GMS）患者中强阿片类药物的处方情况。
对 2010 年 1 月至 2019 年 12 月期间的国家药房索赔数据库进行了回顾性重复横断面分析。评估了 GMS 患者中强阿片类药物的处方情况，包括给药途径、年龄（16-64 岁和≥65 岁）和性别。消费指标包括处方流行率和定义日剂量（DDD）/1000 人/天。使用 95%置信区间（CI）确定流行率比（PR）和百分比和绝对变化。
强阿片类药物的处方流行率从 2010 年的 14.43%上升到 2019 年的 16.28%，其中≥65 岁年龄组的增幅最大。曲马多是最常开的药物，占总强阿片类药物处方的 63.9%。羟考酮的处方流行率从 2010 年的 0.95%上升到 2019 年的 2.68%（PR 2.81，95%CI 2.76，2.87），羟考酮-纳洛酮自上市以来急剧增加（PR 5.23，95%CI 4.98，5.50）。他喷他多的处方流行率从 2012 年（第一个完整的报销年度）到 2019 年从 0.18%上升到 1.58%（PR 8.79，95%CI 8.43，9.16）。在≥65 岁的女性中，强阿片类药物的处方率最高。
本研究发现，2010 年至 2019 年期间，爱尔兰强阿片类药物的处方总体呈上升趋势，尤其是在老年人中。曲马多是最常开的药物，羟考酮和他喷他多的处方在研究期间显著增加。
