Historique
Article de Périodique
Prescription opioid analgesic use in France: trends and impact on morbidity-mortality (2019)
Auteur(s) :
CHENAF, C. ;
KABORE, J. L. ;
DELORME, J. ;
PEREIRA, B. ;
MULLIEZ, A. ;
ZENUT, M. ;
DELAGE, N. ;
ARDID, D. ;
ESCHALIER, A. ;
AUTHIER, N.
Année
2019
Page(s) :
124-134
Langue(s) :
Anglais
Domaine :
Autres substances / Other substances
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus géographique
FRANCE
Thésaurus mots-clés
TRAMADOL
;
MEDICAMENTS
;
EVOLUTION
;
ANALGESIQUES
;
OPIOIDES
;
PREVALENCE
;
BASE DE DONNEES
;
CODEINE
;
OPIUM
;
MORBIDITE
;
MORTALITE
;
FENTANYL
;
DOULEUR
;
CANCER
;
HOSPITALISATION
Résumé :
Background: While data from US and Canada demonstrate an opioid overdose epidemic, very little nation-wide European studies have been published on this topical subject.
Methods: Using a nationally-representative sample of the French Claims database (>700,000 patients), the exhaustive nationwide hospital discharge database, and national mortality registry, all patients dispensed at least one prescription opioid (PO) in 2004-2017 were identified, to describe trends in PO analgesic use, shopping behaviour, opioid-related hospitalizations and deaths. Annual prevalence of PO use and shopping behaviour (>=1 day of overlapping prescriptions from >=2 prescribers, dispensed by >=3 pharmacies) were estimated.
Results: In 2004-2017, the annual prevalence of weak opioid use codeine, tramadol, and opium rose by 150%, 123%, and 244%, respectively (P<0.05). Strong opioid use increased from 0.54% to 1.1% (+104%, P<0.05), significantly for oxycodone (+1950%). Strong opioid use in chronic non-cancer pain rose by 88% (P<0.05) and 1180% for oxycodone. Opioid shopping increased from 0.50% to 0.67% (+34%, P<0.05), associated with higher mortality risk HR=2.8 (95% confidence interval [CI]: 1.2-6.4). Opioid-related hospitalizations increased from 15 to 40 per 1,000,000 population (+167%, 2000-2017), and opioid-related deaths from 1.3 to 3.2 per 1,000,000 population (+146%, 2000-2015).
Conclusions: This study provided a first European approach to a nationwide estimation with complete access to several national registries In 2004-2017 in France, PO use excluding dextropropoxyphene more than doubled. The increase in oxycodone and fentanyl use, and non-trivial increasing trend in opioid-related morbidity-mortality should prompt authorities to closely monitor PO consumption in order to prevent alarming increases in opioid-related morbidity-mortality.
Significance: In 2004-2017, prescription opioid use in France at least doubled and oxycodone use increased particularly, associated with a non-trivial increase in opioid-related morbidity-mortality. Although giving no indication for an "opioid epidemic", these findings call for proper monitoring of opioid use. (This article is protected by copyright. All rights reserved.)
Methods: Using a nationally-representative sample of the French Claims database (>700,000 patients), the exhaustive nationwide hospital discharge database, and national mortality registry, all patients dispensed at least one prescription opioid (PO) in 2004-2017 were identified, to describe trends in PO analgesic use, shopping behaviour, opioid-related hospitalizations and deaths. Annual prevalence of PO use and shopping behaviour (>=1 day of overlapping prescriptions from >=2 prescribers, dispensed by >=3 pharmacies) were estimated.
Results: In 2004-2017, the annual prevalence of weak opioid use codeine, tramadol, and opium rose by 150%, 123%, and 244%, respectively (P<0.05). Strong opioid use increased from 0.54% to 1.1% (+104%, P<0.05), significantly for oxycodone (+1950%). Strong opioid use in chronic non-cancer pain rose by 88% (P<0.05) and 1180% for oxycodone. Opioid shopping increased from 0.50% to 0.67% (+34%, P<0.05), associated with higher mortality risk HR=2.8 (95% confidence interval [CI]: 1.2-6.4). Opioid-related hospitalizations increased from 15 to 40 per 1,000,000 population (+167%, 2000-2017), and opioid-related deaths from 1.3 to 3.2 per 1,000,000 population (+146%, 2000-2015).
Conclusions: This study provided a first European approach to a nationwide estimation with complete access to several national registries In 2004-2017 in France, PO use excluding dextropropoxyphene more than doubled. The increase in oxycodone and fentanyl use, and non-trivial increasing trend in opioid-related morbidity-mortality should prompt authorities to closely monitor PO consumption in order to prevent alarming increases in opioid-related morbidity-mortality.
Significance: In 2004-2017, prescription opioid use in France at least doubled and oxycodone use increased particularly, associated with a non-trivial increase in opioid-related morbidity-mortality. Although giving no indication for an "opioid epidemic", these findings call for proper monitoring of opioid use. (This article is protected by copyright. All rights reserved.)
Affiliation :
Université Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Délégation à la Recherche Clinique et à l'Innovation, Clermont-Ferrand, France