Di Donato Michael F, Mathieson Stephanie, Ferreira Giovanni E, Xia Ting, Tefera Yonas Getaye, Abdel Shaheed Christina, Maher Christopher, Collie Alex
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2025 Mar 12;15(3):e092651. doi: 10.1136/bmjopen-2024-092651.
To describe the prevalence and patterns of opioid analgesic and pain medicine dispenses, and the impact of up-scheduling of low-dose (≤15 mg) codeine-containing products to Australians with accepted workers' compensation time loss claims for musculoskeletal conditions between 2010 and 2019.
Interrupted time series.
Workers' compensation scheme in Victoria, Australia.
Australians with accepted workers' compensation time loss claims for musculoskeletal conditions between 2010 and 2019.
Number and proportion of workers dispensed pain medicines in the first year of claim and the monthly number, percentage of pain medicine dispenses and mean morphine equivalent dispense dose.
Nearly one-third (28.4%, n=22 807) of our sample of 80 324 workers were dispensed any opioid in the first year since the workers' compensation insurer received their claim. There were no significant step or trend changes in the number or percentage of pain medicines dispensed of up-scheduled low-dose codeine. Only 2.9% of workers were ever dispensed up-scheduled low-dose codeine, specifically 2.5% after up-scheduling (1 February 2018). After up-scheduling of low-dose codeine, workers were more likely to be dispensed opioids (excluding codeine) (prevalence ratio (PR) 1.21, 99% CI 1.13, 1.31) or other pain medicines (eg, pregabalin, paracetamol) (PR 1.11, 99% CI 1.03, 1.19) compared with the year prior. There was a significant 28.5% (99% CI 16.3, 41.9) step increase (ie, increase immediately after up-scheduling) in high-dose (>15 mg) codeine with a significant trend decrease (-1.3%, 99% CI -2.5, -0.2).
Up-scheduling low-dose codeine to prescription-only medicines did not significantly change the dispensing of low-dose codeine-containing products to workers with accepted workers' compensation time loss claims for musculoskeletal conditions.
描述阿片类镇痛药和止痛药物的配药流行情况及模式，以及2010年至2019年间将低剂量（≤15毫克）含可待因产品上调为处方药对因肌肉骨骼疾病获得工伤赔偿且有误工索赔的澳大利亚人的影响。
中断时间序列。
澳大利亚维多利亚州的工伤赔偿计划。
2010年至2019年间因肌肉骨骼疾病获得工伤赔偿且有误工索赔的澳大利亚人。
索赔第一年配给止痛药物的工人数量及比例，以及每月止痛药物配给数量、配给百分比和平均吗啡当量配给剂量。
在我们的80324名工人样本中，近三分之一（28.4%，n = 22807）的工人在工伤赔偿保险公司收到其索赔后的第一年配给了任何阿片类药物。上调后的低剂量可待因止痛药物的配给数量或百分比没有显著的阶梯式或趋势变化。只有2.9%的工人曾配给过上调后的低剂量可待因，具体而言，上调后（2018年2月1日）为2.5%。低剂量可待因上调为处方药后，与上一年相比，工人更有可能配给阿片类药物（不包括可待因）（患病率比值（PR）1.21，99%置信区间1.13，1.31）或其他止痛药物（如普瑞巴林、对乙酰氨基酚）（PR 1.11，99%置信区间1.03，1.19）。高剂量（>15毫克）可待因有显著的28.5%（99%置信区间16.3，41.9）的阶梯式增加（即上调后立即增加），且有显著的趋势性下降（-1.3%，99%置信区间-2.5，-0.2）。
将低剂量可待因上调为处方药并未显著改变向因肌肉骨骼疾病获得工伤赔偿且有误工索赔的工人配给含低剂量可待因产品的情况。
