School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; and Caboolture Hospital Pharmacy Department, Metro North Health, Queensland Health, Brisbane, Qld, Australia.
Clinical Pharmacology Department, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, Qld, Australia.
Aust Health Rev. 2023 Apr;47(2):217-225. doi: 10.1071/AH22247.
Objective This study provides an overview of opioid dispensing in Queensland from 2008 to 2018 by recipient age, drug, oral morphine equivalent and remoteness. Methods Data were obtained from the Queensland Monitoring of Drugs of Dependence System database for 2008-18 and analysed using data from the Australian Bureau of Statistics to account for population growth. Opioid dispensing by age, drug, oral morphine equivalent and remoteness were assessed. Results The number of prescriptions for Schedule 8 opioid medicines dispensed in Queensland increased from 190 to 430 per 1000 population over the study period (2.3-fold increase). Oxycodone had the largest increase in dispensing over the study period of 3.1-fold, with tapentadol increasing rapidly since initial Pharmaceutical Benefits Scheme listing in 2013 to the third most dispensed opioid by 2018. By 2018, opioid dispensing among the oldest Queenslanders, those aged 85+ years, occurred at triple the rate for those aged 65-84 years. When adjusted to report oral morphine equivalents (OME) in milligrams (mg), there has been an increase of approximately 1.9-fold over the study period. Results were also presented by geographical area, including a heatmap and analysis by remoteness. Prescriptions dispensed per 1000 population were 416 for major cities, 551 for inner regional and 445 for outer regional, and highlight that inner and outer regional areas have higher rates of prescriptions when compared to major cities (32 and 7% higher, respectively). Conclusion This study highlights changes in opioid prescription dispensing by drug and OME, as well as the variation in dispensing rates when accounting for remoteness. Further studies to link statewide databases, and to better understand drivers for differences in dispensing by location, will provide valuable insights to further inform policy and service provision.
目的 本研究通过受者年龄、药物、口服吗啡当量和偏远程度,概述了 2008 年至 2018 年昆士兰州的阿片类药物配给情况。
方法 本研究从昆士兰州药物依赖监测系统数据库获取了 2008-18 年的数据,并使用澳大利亚统计局的数据进行了分析,以考虑人口增长的因素。评估了年龄、药物、口服吗啡当量和偏远程度的阿片类药物配给情况。
结果 在研究期间,昆士兰州开具的附表 8 类阿片类药物处方数量从每 1000 人 190 份增加到 430 份(增加了 2.3 倍)。奥施康定的配给量在研究期间增加了 3.1 倍,而曲马多自 2013 年列入药品福利计划以来,配给量迅速增加,到 2018 年成为配给量第三大的阿片类药物。到 2018 年,昆士兰州最年长的老年人(85 岁以上)的阿片类药物配给率是 65-84 岁人群的三倍。按毫克(mg)报告口服吗啡当量(OME)调整后,研究期间增加了约 1.9 倍。结果还按地理位置进行了呈现,包括热图和偏远程度分析。每 1000 人分配的处方数为大城市 416 份、内区域 551 份、外区域 445 份,这突出表明,与大城市相比,内区域和外区域的处方率更高(分别高 32%和 7%)。
结论 本研究强调了药物和 OME 处方配给的变化,以及在考虑偏远程度时配给率的差异。进一步研究将全州范围内的数据库联系起来,并更好地了解位置差异对配给的驱动因素,将为进一步为政策和服务提供提供有价值的见解。