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Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016

BACKGROUND: High levels of opioid-related mortality, as well as morbidity, contribute to the excessive opioid-related disease burden in North America, induced by high availability of opioids. While correlations between opioid dispensing levels and mortality outcomes are well-established, fewer evide...

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Autores principales: Jones, Wayne, Kurdyak, Paul, Fischer, Benedikt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374888/
https://www.ncbi.nlm.nih.gov/pubmed/32698815
http://dx.doi.org/10.1186/s12913-020-05530-w
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author Jones, Wayne
Kurdyak, Paul
Fischer, Benedikt
author_facet Jones, Wayne
Kurdyak, Paul
Fischer, Benedikt
author_sort Jones, Wayne
collection PubMed
description BACKGROUND: High levels of opioid-related mortality, as well as morbidity, contribute to the excessive opioid-related disease burden in North America, induced by high availability of opioids. While correlations between opioid dispensing levels and mortality outcomes are well-established, fewer evidence exists on correlations with morbidity (e.g., hospitalizations). METHODS: We examined possible overtime correlations between medical opioid dispensing and opioid-related hospitalizations in Canada, by province, 2007–2016. For dispensing, we examined annual volumes of medical opioid dispensing derived from a representative, stratified sample of retail pharmacies across Canada. Raw dispensing information for ‘strong opioids’ was converted into Defined Daily Doses per 1000 population per day (DDD/1000/day). Opioid-related hospitalization rates referred to opioid poisoning-related admissions by province, for fiscal years 2007–08 to 2016–17, drawn from the national Hospital Morbidity Database. We assessed possible correlations between opioid dispensing and hospitalizations by province using the Pearson product moment correlation; correlation values (r) and confidence intervals were reported. RESULTS: Significant correlations for overtime correlations between population-levels of opioid dispensing and opioid-related hospitalizations were observed for three provinces: Quebec (r = 0.87, CI: 0.49–0.97; p = 0.002); New Brunswick (r = 0.85;CI: 0.43–0.97; p = 0.004) and Nova Scotia (r = 0.78; CI:0.25–0.95; p = 0.012), with an additional province, Saskatchewan, (r = 0.073; CI:-0.07–0.91;p = 0.073) featuring borderline significance. CONCLUSIONS: The correlations observed further add to evidence on opioid dispensing levels as a systemic driver of population-level harms. Notably, correlations were not identified principally in provinces with reported high contribution levels (> 50%) of illicit opioids to mortality, which are not captured by dispensing data and so may have distorted or concealed potential correlation effects due to contamination.
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spelling pubmed-73748882020-07-22 Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016 Jones, Wayne Kurdyak, Paul Fischer, Benedikt BMC Health Serv Res Research Article BACKGROUND: High levels of opioid-related mortality, as well as morbidity, contribute to the excessive opioid-related disease burden in North America, induced by high availability of opioids. While correlations between opioid dispensing levels and mortality outcomes are well-established, fewer evidence exists on correlations with morbidity (e.g., hospitalizations). METHODS: We examined possible overtime correlations between medical opioid dispensing and opioid-related hospitalizations in Canada, by province, 2007–2016. For dispensing, we examined annual volumes of medical opioid dispensing derived from a representative, stratified sample of retail pharmacies across Canada. Raw dispensing information for ‘strong opioids’ was converted into Defined Daily Doses per 1000 population per day (DDD/1000/day). Opioid-related hospitalization rates referred to opioid poisoning-related admissions by province, for fiscal years 2007–08 to 2016–17, drawn from the national Hospital Morbidity Database. We assessed possible correlations between opioid dispensing and hospitalizations by province using the Pearson product moment correlation; correlation values (r) and confidence intervals were reported. RESULTS: Significant correlations for overtime correlations between population-levels of opioid dispensing and opioid-related hospitalizations were observed for three provinces: Quebec (r = 0.87, CI: 0.49–0.97; p = 0.002); New Brunswick (r = 0.85;CI: 0.43–0.97; p = 0.004) and Nova Scotia (r = 0.78; CI:0.25–0.95; p = 0.012), with an additional province, Saskatchewan, (r = 0.073; CI:-0.07–0.91;p = 0.073) featuring borderline significance. CONCLUSIONS: The correlations observed further add to evidence on opioid dispensing levels as a systemic driver of population-level harms. Notably, correlations were not identified principally in provinces with reported high contribution levels (> 50%) of illicit opioids to mortality, which are not captured by dispensing data and so may have distorted or concealed potential correlation effects due to contamination. BioMed Central 2020-07-22 /pmc/articles/PMC7374888/ /pubmed/32698815 http://dx.doi.org/10.1186/s12913-020-05530-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Jones, Wayne
Kurdyak, Paul
Fischer, Benedikt
Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016
title Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016
title_full Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016
title_fullStr Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016
title_full_unstemmed Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016
title_short Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016
title_sort examining correlations between opioid dispensing and opioid-related hospitalizations in canada, 2007–2016
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374888/
https://www.ncbi.nlm.nih.gov/pubmed/32698815
http://dx.doi.org/10.1186/s12913-020-05530-w
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