National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2023 May 17;13(5):e068310. doi: 10.1136/bmjopen-2022-068310.
The POPPY II cohort is an Australian state-based cohort linking data for a population of individuals prescribed opioid medicines, constructed to allow a robust examination of the long-term patterns and outcomes of prescription opioid use.
The cohort includes 3 569 433 adult New South Wales residents who initiated a subsidised prescription opioid medicine between 2003 and 2018, identified through pharmacy dispensing data (Australian Pharmaceutical Benefits Scheme) and linked to 10 national and state datasets and registries including rich sociodemographic and medical services data.
Of the 3.57 million individuals included in the cohort, 52.7% were female and 1 in 4 people were aged ≥65 years at the time of cohort entry. Approximately 6% had evidence of cancer in the year prior to cohort entry. In the 3 months prior to cohort entry, 26.9% used a non-opioid analgesic and 20.5% used a psychotropic medicine. Overall, 1 in 5 individuals were initiated on a strong opioid (20.9%). The most commonly initiated opioid was paracetamol/codeine (61.3%), followed by oxycodone (16.3%).
The POPPY II cohort will be updated periodically, both extending the follow-up duration of the existing cohort, and including new individuals initiating opioids. The POPPY II cohort will allow a range of aspects of opioid utilisation to be studied, including long-term trajectories of opioid use, development of a data-informed method to assess time-varying opioid exposure, and a range of outcomes including mortality, transition to opioid dependence, suicide and falls. The duration of the study period will allow examination of population-level impacts of changes to opioid monitoring and access, while the size of the cohort will also allow examination of important subpopulations such as people with cancer, musculoskeletal conditions or opioid use disorder.
POPPY II 队列是一个基于澳大利亚州的队列，将个人处方阿片类药物的数据联系起来，旨在对处方阿片类药物使用的长期模式和结果进行稳健的检查。
该队列包括 3569433 名新南威尔士州成年居民，他们在 2003 年至 2018 年间开始使用补贴处方阿片类药物，通过药房配药数据（澳大利亚药品福利计划）确定，并与 10 个国家和州数据集和登记处联系起来，包括丰富的社会人口统计学和医疗服务数据。
在队列中包括的 357 万人中，52.7%为女性，1/4 的人在队列进入时年龄≥65 岁。在队列进入前一年，约有 6%的人有癌症证据。在队列进入前 3 个月，26.9%的人使用非阿片类镇痛药，20.5%的人使用精神药物。总体而言，1/5 的人开始使用强阿片类药物（20.9%）。最常开始使用的阿片类药物是对乙酰氨基酚/可待因（61.3%），其次是羟考酮（16.3%）。
POPPY II 队列将定期更新，既延长现有队列的随访时间，又包括开始使用阿片类药物的新个体。POPPY II 队列将允许研究阿片类药物使用的一系列方面，包括阿片类药物使用的长期轨迹、开发一种数据驱动的方法来评估随时间变化的阿片类药物暴露情况，以及一系列结果，包括死亡率、向阿片类药物依赖的转变、自杀和跌倒。研究期间的持续时间将允许检查阿片类药物监测和获取变化对人群水平的影响，而队列的规模也将允许检查癌症、肌肉骨骼疾病或阿片类药物使用障碍等重要亚人群。
