Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
Swiss Med Wkly. 2024 Feb 5;154:3535. doi: 10.57187/s.3535.
To investigate claims patterns for metamizole and other non-opioid analgesics in Switzerland. To characterise users of these non-opioid analgesics regarding sex, age, comedications and canton of residence.
We conducted a retrospective descriptive study using administrative claims data of outpatient prescribed non-opioid analgesics of the Swiss health insurance company Helsana between January 2014 and December 2019. First, we evaluated the number of claims and defined daily doses per year of metamizole, ibuprofen, diclofenac and paracetamol in adults aged 18 years or over. Second, we characterised new users of these non-opioid analgesics in terms of sex, age, claimed comedications and canton of residence.
From 2014 to 2019, among the investigated non-opioid analgesics, metamizole showed the highest increase in claims (+9545 claims, +50%) and defined daily doses (+86,869 defined daily doses, +84%) per 100,000 adults. Metamizole users had the highest median age (62 years [IQR: 44-77]) compared to ibuprofen (47 years [IQR: 33-62]), diclofenac (57 years [IQR: 43-71]) and paracetamol (58 years [IQR: 39-75]) users. Metamizole users also more frequently claimed proton pump inhibitors, anticoagulants, platelet aggregation inhibitors and antihypertensive drugs than users of other non-opioid analgesics. While metamizole was most frequently claimed in German-speaking regions of Switzerland, ibuprofen and paracetamol were most frequently claimed in the French-speaking regions and diclofenac in German- and Italian-speaking regions.
In Switzerland, metamizole was increasingly claimed between 2014 and 2019. Metamizole was most frequently claimed by older adults and patients with comedications suggestive of underlying conditions, which can be worsened or caused by use of nonsteroidal anti-inflammatory drugs. The lack of studies regarding the effectiveness and safety of metamizole in this population warrants further investigation.
研究瑞士扑热息痛和其他非阿片类镇痛药的使用情况。分析这些非阿片类镇痛药使用者的性别、年龄、合并用药情况和居住地。
我们使用瑞士医疗保险 Helsana 公司 2014 年 1 月至 2019 年 12 月的门诊处方非阿片类镇痛药的管理索赔数据进行回顾性描述性研究。首先，我们评估了成人（18 岁及以上）每年扑热息痛、布洛芬、双氯芬酸和对乙酰氨基酚的索赔数量和定义日剂量。其次，我们根据性别、年龄、合并用药情况和居住地来描述这些非阿片类镇痛药的新使用者。
在 2014 年至 2019 年期间，在所调查的非阿片类镇痛药中，扑热息痛的索赔数量（增加 9545 份，增长 50%）和定义日剂量（增加 86869 个，增长 84%）均最高。与布洛芬（47 岁[33-62]）、双氯芬酸（57 岁[43-71]）和对乙酰氨基酚（58 岁[39-75]）使用者相比，扑热息痛使用者的年龄中位数最高（62 岁[44-77]）。扑热息痛使用者也比其他非阿片类镇痛药使用者更常合并使用质子泵抑制剂、抗凝剂、血小板聚集抑制剂和抗高血压药物。虽然扑热息痛在瑞士德语区的使用率最高，但布洛芬和对乙酰氨基酚在法语区的使用率最高，而双氯芬酸在德语和意大利语区的使用率最高。
在瑞士，2014 年至 2019 年间扑热息痛的使用量不断增加。扑热息痛的主要使用者为年龄较大的成年人和合并有提示基础疾病的药物治疗患者，这些基础疾病可能因使用非甾体抗炎药而加重或引发。鉴于缺乏关于扑热息痛在这一人群中的有效性和安全性的研究，需要进一步调查。
