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Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study

BACKGROUND: Opioid analgesics play a key role in pain management but providing access while mitigating risk of misuse and dependence remains a challenge. Tracking global consumption of all opioids over time can help identify emerging patterns and drivers of use. METHODS: Prescription opioid analgesi...

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Autores principales: Jayawardana, Sahan, Forman, Rebecca, Johnston-Webber, Charlotte, Campbell, Allen, Berterame, Stefano, de Joncheere, Cees, Aitken, Murray, Mossialos, Elias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599097/
https://www.ncbi.nlm.nih.gov/pubmed/34820610
http://dx.doi.org/10.1016/j.eclinm.2021.101198
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author Jayawardana, Sahan
Forman, Rebecca
Johnston-Webber, Charlotte
Campbell, Allen
Berterame, Stefano
de Joncheere, Cees
Aitken, Murray
Mossialos, Elias
author_facet Jayawardana, Sahan
Forman, Rebecca
Johnston-Webber, Charlotte
Campbell, Allen
Berterame, Stefano
de Joncheere, Cees
Aitken, Murray
Mossialos, Elias
author_sort Jayawardana, Sahan
collection PubMed
description BACKGROUND: Opioid analgesics play a key role in pain management but providing access while mitigating risk of misuse and dependence remains a challenge. Tracking global consumption of all opioids over time can help identify emerging patterns and drivers of use. METHODS: Prescription opioid analgesic consumption was estimated for 76 countries between 2009 and 2019 using IQVIA MIDAS data. We reported country-level consumption trends in morphine milligram equivalents (MMEs), assessed differences in consumption between high-income (HICs), upper-middle income (UMICs), and low- and lower-middle income countries (LMICs), and identified country-level socioeconomic drivers of consumption using fixed-effects panel regression models. FINDINGS: Global opioid consumption rate declined from 216·3 to 151·5 morphine milligram equivalents per 1,000 inhabitants per day (MID) between 2009 and 2019, with consumption declines in the US and Germany. Overall, consumption rates increased in HICs by a median 36·6 MID (IQR, -7·5 -124·5) with substantial heterogeneity between countries. Median consumption rates were lower in UMICs (23·6 MID) and LMICs (8·3 MID) compared to HICs (345·1 MID) and increased by median 10·4 and 3·7 MID from 2009-2019, respectively. Consumption rates were associated with income (coefficient 18·84, 95% confidence interval 3·8-33·9) and trade (13·59, 1·3-25·8) in UMICs, and physician density (1·95, 1·2-2·7) in LMICs. Tramadol consumption rate increased in the study period and accounted for a relatively large proportion of total opioid volume consumed across all country-income groups. INTERPRETATION: Substantial heterogeneity in global opioid consumption patterns reflect the challenges involved with providing adequate access to opioid treatment while avoiding potential misuse.
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spelling pubmed-85990972021-11-23 Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study Jayawardana, Sahan Forman, Rebecca Johnston-Webber, Charlotte Campbell, Allen Berterame, Stefano de Joncheere, Cees Aitken, Murray Mossialos, Elias EClinicalMedicine Research paper BACKGROUND: Opioid analgesics play a key role in pain management but providing access while mitigating risk of misuse and dependence remains a challenge. Tracking global consumption of all opioids over time can help identify emerging patterns and drivers of use. METHODS: Prescription opioid analgesic consumption was estimated for 76 countries between 2009 and 2019 using IQVIA MIDAS data. We reported country-level consumption trends in morphine milligram equivalents (MMEs), assessed differences in consumption between high-income (HICs), upper-middle income (UMICs), and low- and lower-middle income countries (LMICs), and identified country-level socioeconomic drivers of consumption using fixed-effects panel regression models. FINDINGS: Global opioid consumption rate declined from 216·3 to 151·5 morphine milligram equivalents per 1,000 inhabitants per day (MID) between 2009 and 2019, with consumption declines in the US and Germany. Overall, consumption rates increased in HICs by a median 36·6 MID (IQR, -7·5 -124·5) with substantial heterogeneity between countries. Median consumption rates were lower in UMICs (23·6 MID) and LMICs (8·3 MID) compared to HICs (345·1 MID) and increased by median 10·4 and 3·7 MID from 2009-2019, respectively. Consumption rates were associated with income (coefficient 18·84, 95% confidence interval 3·8-33·9) and trade (13·59, 1·3-25·8) in UMICs, and physician density (1·95, 1·2-2·7) in LMICs. Tramadol consumption rate increased in the study period and accounted for a relatively large proportion of total opioid volume consumed across all country-income groups. INTERPRETATION: Substantial heterogeneity in global opioid consumption patterns reflect the challenges involved with providing adequate access to opioid treatment while avoiding potential misuse. Elsevier 2021-11-13 /pmc/articles/PMC8599097/ /pubmed/34820610 http://dx.doi.org/10.1016/j.eclinm.2021.101198 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research paper
Jayawardana, Sahan
Forman, Rebecca
Johnston-Webber, Charlotte
Campbell, Allen
Berterame, Stefano
de Joncheere, Cees
Aitken, Murray
Mossialos, Elias
Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
title Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
title_full Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
title_fullStr Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
title_full_unstemmed Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
title_short Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
title_sort global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599097/
https://www.ncbi.nlm.nih.gov/pubmed/34820610
http://dx.doi.org/10.1016/j.eclinm.2021.101198
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