Opioid Analgesic Prescription in French Children: A National Population-Based Study

Codeine use was restricted in 2013 and is currently contraindicated for children below the age of 12 years. We examined how the prescription of opioid analgesics in children in France evolved between 2012 and 2018. Our population-based study from the SNIIRAM database (National System of Health Insurance Inter-Regime Information) was designed to determine trends in opioid prescription from 2012 to 2018 in all French children. The number of children who received at least one opioid prescription gradually declined from 452,665 in 2012 (347.5 children per 10,000) to 169,338 in 2018 (130.3 children per 10,000). This decrease was especially marked for codeine (36 children per 10,000 in 2018 vs. 308.5 children per 10,000 in 2012), whereas the number of tramadol prescriptions increased by 171% in 2018 (94.6 children per 10,000). Despite the increase, strong opioids still formed only a small proportion of prescriptions (2.6 children per 10,000 given opioids in 2018). Overall opioid prescriptions in French children dramatically decreased between 2012 and 2018, probably owing to restrictions on the use of codeine. Codeine has been partly replaced by tramadol. Morphine is still probably underused. This suggests that opioids are being used less often for pain management in children.

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Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116136 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6136

Author(s):

Jeonggyo Yoon ◽

Minsun Kang ◽

Jaehun Jung ◽

Min Jae Ju ◽

Sung Hwan Jeong ◽

...

Keyword(s):

Health Insurance ◽

Lung Injury ◽

National Health Insurance ◽

Population Based ◽

Annual Number ◽

Population Based Study ◽

Annual Consumption ◽

Using Data ◽

Water Tanks ◽

Biocidal Product

Humidifier disinfectant (HD) is a household biocidal product used in humidifier water tanks to prevent the growth of microorganisms. In 2011, a series of lung injury cases of unknown causes emerged in children and pregnant women who had used HD in Korea. This study investigated changes in the nationwide number of cases of humidifier disinfectant-associated lung injury (HDLI) in concordance with nationwide HD consumption using data covering the entire Korean population. More than 25 kinds of HD products were sold between 1994 and 2011. The number of diagnosed HDLI, assessed by S27.3 (other injuries of lungs) of the Korea National Health Insurance Service (NHIS) data, sharply increased by 2005, subsequently decreased after 2005, and almost disappeared after 2011 in concordance with the annual number of HD sales. The number of self-reported HDLIs, assessed using data from all suspected HDLI cases registered in the Korea Ministry of Environment, changed with the annual number of HD sales, with a delay pattern, potentially induced by the late awareness of lung injury diseases. The present study suggests that changes in the nationwide annual consumption of HD products were consistent with changes in the annual number of HDLI cases in Korea.

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P 55. Epidemiology, Healthcare Resource Use, and Mortality in Patients with Tuberous Sclerosis Complex: A Population-Based Study on German Health Insurance Data

Clinical Neurophysiology ◽

10.1016/j.clinph.2021.02.371 ◽

2021 ◽

Vol 132 (8) ◽

pp. e25-e26

Author(s):

A. Strzelczyk ◽

S. Schubert-Bast ◽

J.P. Zöllner ◽

A. Simon ◽

G. Wyatt ◽

...

Keyword(s):

Health Insurance ◽

Tuberous Sclerosis Complex ◽

Resource Use ◽

Healthcare Resource ◽

Population Based ◽

Healthcare Resource Use ◽

Health Insurance Data ◽

Population Based Study ◽

German Health ◽

Insurance Data

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Postoperative Pain and Opioid Use Following Surgical Treatment of Ankle Fractures

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00339 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0033

Author(s):

Matthew Pate ◽

Jacob Hall ◽

John Anderson ◽

Donald Bohay ◽

John Maskill ◽

...

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Ankle Fracture ◽

Management Practices ◽

Opioid Analgesic ◽

The United States ◽

Ankle Fractures ◽

Opioid Use ◽

Opioid Prescription ◽

Opioid Medication

Category: Ankle, Bunion, Trauma Introduction/Purpose: Chronic opioid abuse is one of the greatest public health challenges in the United States. The most common first exposure to opioids comes from acute care prescriptions, such as those after surgery. Moreover, opioids are often prescribed excessively, with current estimates suggesting ˜75% of the pills prescribed are unused. Ankle fractures are the most common operatively treated fracture in orthopaedic surgery, and management of acute pain following surgery is challenging. The optimal perioperative pain regimen is still a point of controversy, as there is limited data available regarding appropriate amount of opioid to prescribe. This study evaluates opioid prescribing techniques of multiple foot and ankle surgeons, and associated patient outcomes. We aim to help surgeons improve their pain management practices and to limit opioid overprescription. Methods: Chart review and phone survey were performed on forty two adult patients within three to six months of ankle fracture fixation at our institution. These patients were offered to voluntarily participate in a standardized questionnaire regarding pain scores, opioid use, non-opioid analgesic use, pain management satisfaction, and patient prescription education. Results: 57% of patients reported that they were given “more” or ”much more” opioid medication than needed, 38% stated that they were given the “right amount”, and 5% reported that they were given ”less” or “much less” than needed. 40.0% were on opioids prior to operation. 53.5% did not require refill of discharge opioid prescriptions, 30.2% of patients did not fill any posteroperative opioid prescription. 16.3% of patients filled their discharge prescription and at least one additionall refill (mean refill = 2.22). Mean number of reported opioid pills taken after surgery was 17.4. Mean satisfaction with overall pain management at phone follow up was 8.6/10. Conclusion: While postoperative pain and management vary substantially, a majority of patients feel that they are given more opioid medication than necessary following ankle fracture repair, and a majority of opioid prescriptions are not completely used. Going forward, it is likely that a majority of patients could experience the same beneficial results with less prescription opioid pain medication, which would reduce overpresciption and potential misuse.

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Cost and outcomes of the ultrasound screening program for birth defects over time: a population-based study in France

BMJ Open ◽

10.1136/bmjopen-2019-036566 ◽

2020 ◽

Vol 10 (7) ◽

pp. e036566

Author(s):

Clément Ferrier ◽

Babak Khoshnood ◽

Ferdinand Dhombres ◽

Hanitra Randrianaivo ◽

Isabelle Perthus ◽

...

Keyword(s):

Health Insurance ◽

Cost Effectiveness ◽

Birth Defects ◽

Screening Programme ◽

Population Based ◽

Ultrasound Screening ◽

Cost Effectiveness Ratio ◽

Population Based Study ◽

Prenatal Detection ◽

The Cost

ObjectiveTo assess trends in the average costs and effectiveness of the French ultrasound screening programme for birth defects.DesignA population-based study.SettingNational Public Health Insurance claim database.ParticipantsAll pregnant women in the ‘Echantillon Généraliste des Bénéficiaires’, a permanent representative sample of 1/97 of the individuals covered by the French Health Insurance System.Main outcomes measuresTrends in the costs and in the average cost-effectiveness ratio (ACER) of the screening programme (in € per case detected antenatally), per year, between 2006 and 2014. incremental cost-effectiveness ratio (ICER) from 1 year to another were also estimated. We assessed costs related to the ultrasound screening programme of birth defects excluding the specific screening of Down’s syndrome. The outcome for effectiveness was the prenatal detection rate of birth defects, assessed in a previous study. Linear and logistic regressions were used to analyse time trends.ResultsDuring the study period, there was a slight decrease in prenatal detection rates (from 58.2% in 2006 to 55.2% in 2014; p=0.015). The cost of ultrasound screening increased from €168 in 2006 to €258 per pregnancy in 2014 (p=0.001). We found a 61% increase in the ACER for ultrasound screening during the study period. ACERs increased from €9050 per case detected in 2006 to €14 580 per case detected in 2014 (p=0.001). ICERs had an erratic pattern, with a strong tendency to show that any increment in the cost of screening was highly cost ineffective.ConclusionEven if the increase in costs may be partly justified, we observed a diminishing returns for costs associated with the prenatal ultrasound screening of birth defects, in France, between 2006 and 2014.

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