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Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals
Objective: To characterize the trend of opioid use (number of users, dispensations and oral morphine milligram equivalents) in Catalonia (Spain). Design, setting, and participants: This population-based cohort study included all individuals aged 18 years or older, registered in the Information Syste...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213744/ https://www.ncbi.nlm.nih.gov/pubmed/35754470 http://dx.doi.org/10.3389/fphar.2022.912361 |
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author | Xie, Junqing Strauss, Victoria Y. Collins, Gary S. Khalid, Sara Delmestri, Antonella Turkiewicz, Aleksandra Englund, Martin Tadrous, Mina Reyes, Carlen Prieto-Alhambra, Daniel |
author_facet | Xie, Junqing Strauss, Victoria Y. Collins, Gary S. Khalid, Sara Delmestri, Antonella Turkiewicz, Aleksandra Englund, Martin Tadrous, Mina Reyes, Carlen Prieto-Alhambra, Daniel |
author_sort | Xie, Junqing |
collection | PubMed |
description | Objective: To characterize the trend of opioid use (number of users, dispensations and oral morphine milligram equivalents) in Catalonia (Spain). Design, setting, and participants: This population-based cohort study included all individuals aged 18 years or older, registered in the Information System for Research in Primary Care (SIDIAP), which covers >75% of the population in Catalonia, Spain, from 1 January 2007, to 31 December 2019. Main exposure and outcomes: The exposures were all commercialized opioids and their combinations (ATC-codes): codeine, tramadol, oxycodone, tapentadol, fentanyl, morphine, and other opioids (dihydrocodeine, hydromorphone, dextropropoxyphene, buprenorphine, pethidine, pentazocine). The main outcomes were the annual figures per 1,000 individuals of 1) opioid users, 2) dispensations, and 3) oral morphine milligram equivalents (MME). Results were stratified separately by opioid types, age (5-year age groups), sex (male or female), living area (rural or urban), and socioeconomic status (from least, U1, to most deprived, U5). The overall trends were quantified using the percentage change (PC) between 2007 and 2019. Results: Among 4,656,197 and 4,798,114 residents from 2007 to 2019, the number of opioid users, dispensations and morphine milligram equivalents per 1,000 individuals increased 12% (percentage change: 95% confidence interval (CI) 11.9–12.3%), 105% (95% confidence interval 83%–126%) and 339% (95% CI 289%–390%) respectively. Tramadol represented the majority of opioid use in 2019 (61, 59, and 54% of opioid users, dispensations, and total MME, respectively). Individuals aged 80 years or over reported the sharpest increase regarding opioid users (PC: 162%), dispensations (PC: 424%), and MME (PC: 830%). Strong opioids were increasingly prescribed for non-cancer pains over the years. Conclusion: Despite the modest increase of opioid users, opioid dispensations and MME increased substantially, particularly in the older population. In addition, strong opioids were incrementally indicated for non-cancer pains over the years. These findings suggest a transition of opioid prescriptions from intermittent to chronic and weak to strong and call for more rigorous opioid stewardship. |
format | Online Article Text |
id | pubmed-9213744 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92137442022-06-23 Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals Xie, Junqing Strauss, Victoria Y. Collins, Gary S. Khalid, Sara Delmestri, Antonella Turkiewicz, Aleksandra Englund, Martin Tadrous, Mina Reyes, Carlen Prieto-Alhambra, Daniel Front Pharmacol Pharmacology Objective: To characterize the trend of opioid use (number of users, dispensations and oral morphine milligram equivalents) in Catalonia (Spain). Design, setting, and participants: This population-based cohort study included all individuals aged 18 years or older, registered in the Information System for Research in Primary Care (SIDIAP), which covers >75% of the population in Catalonia, Spain, from 1 January 2007, to 31 December 2019. Main exposure and outcomes: The exposures were all commercialized opioids and their combinations (ATC-codes): codeine, tramadol, oxycodone, tapentadol, fentanyl, morphine, and other opioids (dihydrocodeine, hydromorphone, dextropropoxyphene, buprenorphine, pethidine, pentazocine). The main outcomes were the annual figures per 1,000 individuals of 1) opioid users, 2) dispensations, and 3) oral morphine milligram equivalents (MME). Results were stratified separately by opioid types, age (5-year age groups), sex (male or female), living area (rural or urban), and socioeconomic status (from least, U1, to most deprived, U5). The overall trends were quantified using the percentage change (PC) between 2007 and 2019. Results: Among 4,656,197 and 4,798,114 residents from 2007 to 2019, the number of opioid users, dispensations and morphine milligram equivalents per 1,000 individuals increased 12% (percentage change: 95% confidence interval (CI) 11.9–12.3%), 105% (95% confidence interval 83%–126%) and 339% (95% CI 289%–390%) respectively. Tramadol represented the majority of opioid use in 2019 (61, 59, and 54% of opioid users, dispensations, and total MME, respectively). Individuals aged 80 years or over reported the sharpest increase regarding opioid users (PC: 162%), dispensations (PC: 424%), and MME (PC: 830%). Strong opioids were increasingly prescribed for non-cancer pains over the years. Conclusion: Despite the modest increase of opioid users, opioid dispensations and MME increased substantially, particularly in the older population. In addition, strong opioids were incrementally indicated for non-cancer pains over the years. These findings suggest a transition of opioid prescriptions from intermittent to chronic and weak to strong and call for more rigorous opioid stewardship. Frontiers Media S.A. 2022-06-08 /pmc/articles/PMC9213744/ /pubmed/35754470 http://dx.doi.org/10.3389/fphar.2022.912361 Text en Copyright © 2022 Xie, Strauss, Collins, Khalid, Delmestri, Turkiewicz, Englund, Tadrous, Reyes and Prieto-Alhambra. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pharmacology Xie, Junqing Strauss, Victoria Y. Collins, Gary S. Khalid, Sara Delmestri, Antonella Turkiewicz, Aleksandra Englund, Martin Tadrous, Mina Reyes, Carlen Prieto-Alhambra, Daniel Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals |
title | Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals |
title_full | Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals |
title_fullStr | Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals |
title_full_unstemmed | Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals |
title_short | Trends of Dispensed Opioids in Catalonia, Spain, 2007–19: A Population-Based Cohort Study of Over 5 Million Individuals |
title_sort | trends of dispensed opioids in catalonia, spain, 2007–19: a population-based cohort study of over 5 million individuals |
topic | Pharmacology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213744/ https://www.ncbi.nlm.nih.gov/pubmed/35754470 http://dx.doi.org/10.3389/fphar.2022.912361 |
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