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:	Sahan Jayawardana, Rebecca Forman, Charlotte Johnston-Webber, Allen Campbell, Stefano Berterame, Cees de Joncheere, Murray Aitken, Elias Mossialos
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b985ef32082d4c459b70fac7fa602051
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spelling	oai:doaj.org-article:b985ef32082d4c459b70fac7fa6020512021-11-14T04:35:13ZGlobal consumption of prescription opioid analgesics between 2009-2019: a country-level observational study2589-537010.1016/j.eclinm.2021.101198https://doaj.org/article/b985ef32082d4c459b70fac7fa6020512021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S258953702100479Xhttps://doaj.org/toc/2589-5370Background: 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.Sahan JayawardanaRebecca FormanCharlotte Johnston-WebberAllen CampbellStefano BerterameCees de JoncheereMurray AitkenElias MossialosElsevierarticleMedicine (General)R5-920ENEClinicalMedicine, Vol 42, Iss , Pp 101198- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Sahan Jayawardana Rebecca Forman Charlotte Johnston-Webber Allen Campbell Stefano Berterame Cees de Joncheere Murray Aitken Elias Mossialos Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
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.
format	article
author	Sahan Jayawardana Rebecca Forman Charlotte Johnston-Webber Allen Campbell Stefano Berterame Cees de Joncheere Murray Aitken Elias Mossialos
author_facet	Sahan Jayawardana Rebecca Forman Charlotte Johnston-Webber Allen Campbell Stefano Berterame Cees de Joncheere Murray Aitken Elias Mossialos
author_sort	Sahan Jayawardana
title	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_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_sort	global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/b985ef32082d4c459b70fac7fa602051
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Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study

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