Oladottir Sigridur, Jonsson Jon Steinar, Tomasdottir Margret Olafia, Hrafnkelsson Hannes, Sigurdsson Emil Larus
Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.
Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland, The primary health care of the capital area, Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland.
Laeknabladid. 2021 Oct;107(10):455-459. doi: 10.17992/lbl.2021.10.654.
In recent decades there has been a notable increase in the prescription of opioids in western countries. With this rise in use of opioids the risk of side effects, opioid abuse and deaths linked to opioids have become more apparent. The increase in opioid prescription may partly stem from a change in attitude in relation to pain management. Research has shown that pain is among the most common reasons people seek medical care and chronic pain is prevalent. Iceland is leading the Nordic countries in opioid prescriptions.
To examine prescriptions of opioids in primary car in Iceland for all age group from 2008 to 2017.
The research included all opioid prescription in every health clinic in the capital area in Iceland the between 2008 and 2017. Population in the capital area in this time period was between 201 and 222 thousand people. Data was collected from medical records database of the primary health care and approximatley 68.000 individuals had received a prescription for opioids during the research period.
During the research period there was a 17,2% (p<0,01) increase in DDD/1000 inhabitants/day (Defined daily dose) for opioids. About a third of those who got the prescription were men and that ratio did not change during the period. proportionately, the biggest change in DDD/1000 inhabitants/day was in the age group made of people 90 years old and older, about 40,5% ((p<0,01)). The biggest increase in number of people getting a prescription for opioids was in the age group 30-39, about 25,5% ((p<0,01)). Number of prescriptions increased in every category of opioids, measured in DDD/1000 inhabitants/day,15,3% ((p<0,01)) in parkódin, 20,7% ((p<0,01)) in parkódín forte, 4,7% (p<0,01)) in tramadol and 85,6% (p<0,01) in the strongest opioids.
the evolution of prescriptions for every type of opioid to the clients of the health clinics in the capital area that occured in the years from 2008 to 2017, proportionately highest for the strongest opioids, should encourage a review of pain treatment within the health clinics and development within that field.
近几十年来，西方国家阿片类药物的处方量显著增加。随着阿片类药物使用量的上升，其副作用、滥用及相关死亡风险愈发明显。阿片类药物处方量的增加可能部分源于疼痛管理观念的转变。研究表明，疼痛是人们寻求医疗护理的最常见原因之一，且慢性疼痛普遍存在。冰岛在北欧国家中阿片类药物处方量领先。
研究2008年至2017年冰岛所有年龄组在初级医疗保健中阿片类药物的处方情况。
该研究涵盖了冰岛首都地区2008年至2017年各健康诊所的所有阿片类药物处方。此时间段首都地区人口在20.1万至22.2万之间。数据从初级医疗保健的病历数据库收集，研究期间约6.8万人曾接受阿片类药物处方。
研究期间，阿片类药物的限定日剂量（DDD）/1000居民/天增加了17.2%（p<0.01）。约三分之一的处方获得者为男性，这一比例在此期间未变。按比例计算，DDD/1000居民/天变化最大的是90岁及以上年龄组，约为40.5%（p<0.01）。获得阿片类药物处方人数增加最多的是30 - 39岁年龄组，约为25.5%（p<0.01）。以DDD/1000居民/天衡量，各类阿片类药物的处方量均增加，帕罗西汀增加了15.3%（p<0.01），强力帕罗西汀增加了20.7%（p<0.01），曲马多增加了4.7%（p<0.01），最强效阿片类药物增加了85.6%（p<0.01）。
2008年至2017年首都地区健康诊所各类阿片类药物处方的变化情况，最强效阿片类药物的变化比例最高，这应促使对健康诊所内的疼痛治疗进行审查，并推动该领域的发展。
