scholarly journals Comparison of Two Different Analgesic Prescription Strategies and Healthcare Systems: Slovenia vs. the Netherlands

2021 ◽  
Vol 2 ◽  
Author(s):  
Ajda Bedene ◽  
Anita Strmljan ◽  
Eveline L. A. van Dorp ◽  
Mitja Udovič ◽  
Willem M. Lijfering ◽  
...  
Keyword(s):  
The Netherlands ◽  
Medication Use ◽  
Pain Medication ◽  
Opioid Use ◽  
Pharmacy Claims ◽  
Frequent Use ◽  
Prescribing Practice ◽  
Inflammatory Drugs ◽  
Strong Opioids ◽  
Prescription Databases

Background: Prescribing practice of pain medication is changing in the Netherlands; opioids are used more often instead of nonsteroidal anti-inflammatory drugs (NSAIDs), therefore we aimed to compare the use of pain medication with Slovenia which has stringent prescribing rules for strong opioids.Methods: We conducted a cohort study into national prescription databases of the Netherlands and Slovenia covering pharmacy claims between January 1, 2013 and December 31, 2019. In the analysis about 17 million Dutch and 2 million Slovenian residents were included.Findings: The use of opioids and NSAIDs was higher in Slovenia than in the Netherlands. More frequent use of opioids in Slovenia could be almost entirely explained by weak opioids (about 6% of the population), whereas they were prescribed 50% less frequently in the Netherlands. The opioid use has increased by about 20% in the Netherlands (4.85 and 6.00% of the population in 2013 and 2018, respectively), and the majority of this increase could be explained by strong opioids (4.05% in 2018), specifically, by oxycodone whose use increased by more than 2-fold between 2013 and 2019. In comparison, oxycodone was seldomly used in Slovenia (about 0.3% of the population received a prescription in a year).Interpretation: When medication use is controlled by stringent prescribing rules, like for strong opioids in Slovenia, the use is lower as compared to when such rules do not exist.

scholarly journals Musculoskeletal Disorders, Pain Medication and In-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study

2021 ◽  
Vol 18 (13) ◽  
pp. 6804
Author(s):  
Tak-Kyu Oh ◽  
In-Ae Song ◽  
Joon Lee ◽  
Woosik Eom ◽  
Young-Tae Jeon
Keyword(s):  
South Korea ◽  
Hospital Mortality ◽  
Musculoskeletal Disorders ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Pain Medication ◽  
Multivariate Logistic Regression ◽  
Lower Back ◽  
Inflammatory Drugs ◽  
Strong Opioids

We aimed to investigate whether comorbid musculoskeletal disorders (MSD)s and pain medication use was associated with in-hospital mortality among patients with coronavirus disease 2019 (COVID-19). Adult patients (≥20 years old) with a positive COVID-19 diagnosis until 5 June 2020 were included in this study, based on the National Health Insurance COVID-19 database in South Korea. MSDs included osteoarthritis, neck pain, lower back pain, rheumatoid arthritis, and others, while pain medication included paracetamol, gabapentin, pregabalin, glucocorticoid, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids (strong and weak opioids), and benzodiazepine. Primary endpoint was in-hospital mortality. A total of 7713 patients with COVID-19 were included, and in-hospital mortality was observed in 248 (3.2%) patients. In multivariate logistic regression analysis, no MSDs (p > 0.05) were significantly associated with in-hospital mortality. However, in-hospital mortality was 12.73 times higher in users of strong opioids (odds ratio: 12.73, 95% confidence interval: 2.44–16.64; p = 0.002), while use of paracetamol (p = 0.973), gabapentin or pregabalin (p = 0.424), glucocorticoid (p = 0.673), NSAIDs (p = 0.979), weak opioids (p = 0.876), and benzodiazepine (p = 0.324) was not associated with in-hospital mortality. In South Korea, underlying MSDs were not associated with increased in-hospital mortality among patients with COVID-19. However, use of strong opioids was significantly associated with increased in-hospital mortality among the patients.

869 Opioid Utilization in Pediatric Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S273-S274
Author(s):  
Niti Shahi ◽  
Maxene Meier ◽  
Ryan Phillips ◽  
Gabrielle Shirek ◽  
Ashley Banks ◽  
...  
Keyword(s):  
Parent Education ◽  
Multimodal Therapy ◽  
Medication Use ◽  
Pain Medication ◽  
Categorical Variables ◽  
Burn Patients ◽  
Opioid Use ◽  
Over The Counter ◽  
Pain Medications ◽  
Opioid Administration

Abstract Introduction Childhood burns are extremely common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, disrupting care and increasing the risk of post-traumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of burns in pediatric patients. We sought to evaluate the current use of multimodal therapy as well as the use, storage, and disposal of opioids in this patient population. Methods We prospectively surveyed parents of pediatric burn patients (0–18 years old) who presented to the burn clinic within two weeks of burn injury. Parents were surveyed regarding over-the-counter pain medication use and opioid medication use, storage, and disposal in the treatment of their child. Medians and interquartile ranges were used to describe continuous variables and frequencies and percentages were used for categorical variables. Results A total of 92 parents of burn-injured children were surveyed at a single institution in the outpatient burn clinic. The median age of burn-injured children was 3.1 years old, and 50% of patients were male. The majority had a TBSA of 1%. The hand was the most frequently burned location (45.7%). Acetaminophen (58.7%) and ibuprofen (69.6%) were the most common treatments for both constant and breakthrough pain. Approximately 28% (26/92) of patients were prescribed opioids, of which 18.5% (17/92) filled their prescription. Only 29% of patients (5/17) consumed their entire prescription, and a median of 3 doses of opioids remained for those who did not finish the entire prescription. Parents most commonly decided to give their children opioid pain medications because “my child is in severe pain” or “I give my child pain medications as scheduled (written on prescription).” Approximately 40% (7/17) of patients who filled opioid prescriptions stored them in a locked area, and only 35.3% (6/17) were educated on how to dispose of excess opioid pain medication. Conclusions Presently, multimodal therapy with over-the-counter pain medications is used to treat the majority of pediatric burns. This study demonstrates an increased need for education on opioid administration, storage, and disposal for parents of burn-injured children. Applicability of Research to Practice We aimed to evaluate what current trends in opioid use are in pediatric burn patients and areas for improvement in parent education for over-the-counter pain medication use, opioid use, opioid storage, and disposal. From the study, we were able to glean that the majority of patients are successfully managed with over-the-counter pain medications. However, parents and patients managed with opioids need additional education on appropriate administration of opioid pain medications, safe locked storage of opioids, and opioid disposal. This demonstrates an area for quality improvement inpatient and outpatient.

Changes in opioid prescribing behaviour in Denmark, Sweden and Norway - 2006-2014

2016 ◽  
Vol 12 (1) ◽  
pp. 121-121
Author(s):  
L. Jarlbaek ◽  
P. Joergensen
Keyword(s):  
Oral Morphine ◽  
Opioid Use ◽  
The Public ◽  
Opioid Prescribing ◽  
Defined Daily Doses ◽  
Consumption Data ◽  
Prescribing Behaviour ◽  
Strong Opioids ◽  
Opioid Users ◽  
Prescription Databases

Abstract Aims A country’s use of opioids is frequently debated in the public, usually based on rough figures from prescription databases made for consumption registration purposes. However, these databases hold much more detailed information that can be processed to increase knowledge and insight into nationally opioid prescribing-behaviour. This study aims to provide a more detailed picture of opioid prescribing and its changes in Denmark, Sweden and Norway during 2006-2014. Methods Data on opioid-use (ATC; N02A) were downloaded from each country’s publically assessable prescription-databases. Consumption-data were converted from defined daily doses (DDDs) to mg oral morphine equivalents (omeqs). Changes in choice of opioid-types, use and number of users were presented using descriptive statistics and compared. Results Opioid users: During the whole period, Norway had the highest, and Denmark the lowest, number of opioid users/1000 inhabitants. In 2006, Norway, Sweden and Denmark had 98, 79, 66 users/1000 inhabitants. In 2014 the numbers were 105, 78, 75 users/1000 inhabitants, respectively. Opioid use/user: During the whole period, Norway had the lowest, and Denmark the highest use/user. In 2006, the mean use/user was 1979, 3615, 6025 mg omeq/user in Norway, Sweden and Denmark respectively. In 2014 the corresponding use was 2426,3473,6361 mg omeq/user. The preferred choices of opioid-types changed during the period for all three countries. The balance between use of weak or strong opioids showed more prominent changes for Norway and Sweden compared to Denmark. Conclusions Three nations, closely related in culture and geo graphically, showed significant differences and changes in opioid prescribing behaviour. This knowledge can easily be overlooked using the traditional way of presenting opioid consumption statistics. More detailed and clinically relevant presentation can increase the knowledge of doctors’ opioid prescribing behaviour, that can be related to changes in the society or health care system, like demography, legislation and guidelines from authorities.

scholarly journals OPIOID USE IN ADOLESCENTS FOLLOWING HIP AND KNEE ARTHROSCOPY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0008
Author(s):  
S. Clifton Willimon ◽  
Michael Busch ◽  
Melissa Christino ◽  
Belinda Schaafsma ◽  
Crystal Perkins
Keyword(s):  
Risk Factors ◽  
Pain Control ◽  
Knee Arthroscopy ◽  
Medication Use ◽  
Pain Medication ◽  
Opioid Use ◽  
Pain Scores ◽  
Pain Medications ◽  
Post Operative Pain ◽  
Opioid Medications

Background: The use and misuse of opioid medications has been declared an epidemic and public health emergency by the Centers for Disease Control. From 1999 – 2016, there was a 5-fold increase in overdose deaths secondary to opioids1. Pain control is an important component of post-operative care following orthopaedic surgery and opioid medications are commonly prescribed. The purpose of this study is to describe the average opioid use among adolescents following hip and knee arthroscopy. Methods: All patients less than 21 years of age undergoing ACL reconstruction, simple knee arthroscopy (plica and fat pad debridement, loose body removal, partial meniscectomy, or chondroplasty), and hip arthroscopy for femoroacetabular impingement were prospectively enrolled in this IRB-approved study. This is an interim report for an ongoing study with anticipated completion of enrollment in December 2018. All patients received hydrocodone-acetaminophen 5-325 mg for post-operative pain control. The number of pills prescribed was based on physician preference and was not dictated by the study. Patients and their families completed a medication logbook to track all doses of pain medication and associated pain scores. Risk factors for hydrocodone use following surgery were analyzed, including age, sex, race, pre-operative use of narcotic pain medications, surgical factors, and post-operative VAS pain scores. Results: A total of 65 patients were enrolled and completed the medication logbook, including 37 females and 28 males with a mean age of 15.6 years (range 7 – 20 years). Patients received a prescription for an average of 28 hydrocodone tablets (range 10 – 60) and 64 patients (98%) filled the prescription. The mean number and range of hydrocodone tablets consumed and remaining at the end of treatment and VAS pain scores at the time the patients consumed the pain medication are listed in the figure below. Forty-two patients (65%) reported one or more side effects from the hydrocodone, with the most common being drowsiness and constipation. There were no risk factors that predicted increased use of hydrocodone following ACL reconstruction or knee arthroscopy. Female sex and higher post-operative VAS pain scores predicted greater use of hydrocodone in patients following hip arthroscopy. Conclusions: Opioid medication use in adolescents following hip and knee arthroscopy is significantly less than the quantity of tablets prescribed, with 60% of the medication we prescribed remaining unused in the post-operative period. We recommend orthopaedic surgeons responsibly prescribe pain medications using evidence-based data or the results of their own experience monitoring medication consumption. Additionally, and important in the setting of the “opioid epidemic,” physicians must counsel patients and families of post-operative pain expectations and appropriate medication use. This study will provide the framework for the future development of educational resources regarding prescribing and use of pain medications for healthcare providers, patients, and caregivers. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017 [Table: see text]

scholarly journals Psychotropic and pain medication use in individuals with traumatic brain injury—a Swedish total population cohort study of 240 000 persons

2021 ◽  
Vol 92 (5) ◽  
pp. 519-527
Author(s):  
Yasmina Molero ◽  
David James Sharp ◽  
Brian Matthew D'Onofrio ◽  
Henrik Larsson ◽  
Seena Fazel
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Total Population ◽  
Medication Use ◽  
Population Based ◽  
Pain Medication ◽  
Short Term ◽  
Pain Medications ◽  
Before And After

ObjectiveTo examine psychotropic and pain medication use in a population-based cohort of individuals with traumatic brain injury (TBI), and compare them with controls from similar backgrounds.MethodsWe assessed Swedish nationwide registers to include all individuals diagnosed with incident TBI between 2006 and 2012 in hospitals or specialist outpatient care. Full siblings never diagnosed with TBI acted as controls. We examined dispensed prescriptions for psychotropic and pain medications for the 12 months before and after the TBI.ResultsWe identified 239 425 individuals with incident TBI, and 199 658 unaffected sibling controls. In the TBI cohort, 36.6% had collected at least one prescription for a psychotropic or pain medication in the 12 months before the TBI. In the 12 months after, medication use increased to 45.0%, an absolute rate increase of 8.4% (p<0.001). The largest post-TBI increases were found for opioids (from 16.3% to 21.6%, p<0.001), and non-opioid pain medications (from 20.3% to 26.6%, p<0.001). The majority of prescriptions were short-term; 20.6% of those prescribed opioids and 37.3% of those with benzodiazepines collected prescriptions for more than 6 months. Increased odds of any psychotropic or pain medication were associated with individuals before (OR: 1.62, 95% CI: 1.59 to 1.65), and after the TBI (OR: 2.30, 95% CI: 2.26 to 2.34) as compared with sibling controls, and ORs were consistently increased for all medication classes.ConclusionHigh rates of psychotropic and pain medications after a TBI suggest that medical follow-up should be routine and review medication use.

scholarly journals Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

2021 ◽  
pp. tobaccocontrol-2021-056528
Author(s):  
Thomas Martinelli ◽  
Math J J M Candel ◽  
Hein de Vries ◽  
Reinskje Talhout ◽  
Vera Knapen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Tobacco Use ◽  
Tobacco Smoking ◽  
Longitudinal Design ◽  
Positive Association ◽  
Cigarette Use ◽  
Convenience Sample ◽  
Frequent Use ◽  
Never Smokers

BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.DesignThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.FindingsConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).ConclusionOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.

Developing school–pharmacist partnerships to enhance correct medication use and pain medication literacy in Taiwan

2015 ◽  
Vol 55 (6) ◽  
pp. 595-602 ◽  
Author(s):  
Fong-Ching Chang ◽  
Hsueh-Yun Chi ◽  
Li-Jung Huang ◽  
Chun-Hsien Lee ◽  
Jyun-Long Yang ◽  
...  
Keyword(s):  
Medication Use ◽  
Pain Medication

scholarly journals Pain Medication Use after Spine Surgery

Pain Medicine ◽  
2014 ◽  
Vol 15 (12) ◽  
pp. 2161-2162 ◽  
Author(s):  
Hiroyuki Yoshihara
Keyword(s):  
Spine Surgery ◽  
Medication Use ◽  
Pain Medication
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