Trends in Israeli community-based opioid prescribing, 2010-2020, an observational study of the country's largest HMO.

IF 3.5 4区 医学 Q1 HEALTH POLICY & SERVICES Israel Journal of Health Policy Research Pub Date : 2023-11-16 DOI:10.1186/s13584-023-00581-w
Reuven L Dressler, Ehud Kaliner, Matan J Cohen
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Abstract

Background: Prescription opioids are widely used for pain control and palliative care but have been associated with a variety of untoward effects, including opioid use disorder, addiction, and increased mortality. Patterns of opioid use in Israel are to date poorly described.

Methods: Using a community-based database, the authors performed a retrospective analysis of filled opioid prescriptions of Israeli HMO members 18 years of age or older during the years of 2010-2020 that filled at least one opioid prescription. Morphine milligram equivalent (MME) calculations were stratified by presence or absence of oncology diagnosis and by specific opioid medication.

Results: The percentage of HMO members who filled at least one opioid prescription increased every year from 2.1% in 2010 to 4.2% in 2020. There was an increase in the MME per prescription (44.2%), daily MME per capita (142.1%) and MME per prescription-filling patient (39%) from 2010 to 2020. Increased prescription opioid use is driven by a small group of non-oncological patients, which is less than 1.5% of opioid-prescribed patients and 0.1% of the adult population, primarily owing to fentanyl use.

Conclusion: Supervision and control of opioid prescriptions in Israel should be a focused effort directed at patients prescribed uniquely high dosages rather than a population-wide strategy that focuses on all patients prescribed opioids. This should be complemented by improved physician training and access to non-opioid therapies, as well as improved data collection and analysis.

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以色列社区阿片类药物处方趋势,2010-2020年,一项对该国最大的卫生组织的观察性研究。
背景:处方阿片类药物被广泛用于疼痛控制和姑息治疗,但与各种不良反应有关,包括阿片类药物使用障碍、成瘾和死亡率增加。迄今为止,对以色列阿片类药物使用模式的描述很少。方法:使用基于社区的数据库,作者对以色列HMO成员在2010-2020年期间填写至少一种阿片类药物处方的18岁或以上的阿片类药物处方进行了回顾性分析。吗啡毫克当量(MME)计算按有无肿瘤诊断和特定阿片类药物进行分层。结果:HMO成员服用至少一种阿片类药物处方的比例从2010年的2.1%每年增加到2020年的4.2%。2010 - 2020年,单处方MME(44.2%)、人均日MME(142.1%)和填药患者人均MME(39%)均有所增加。处方阿片类药物使用的增加是由一小部分非肿瘤患者推动的,他们占阿片类药物处方患者的不到1.5%,占成年人口的0.1%,主要是由于芬太尼的使用。结论:以色列对阿片类药物处方的监督和控制应集中针对处方独特高剂量的患者,而不是针对所有处方阿片类药物的患者的全民战略。应通过改进医生培训和获得非阿片类药物治疗以及改进数据收集和分析来补充这一点。
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来源期刊
CiteScore
6.20
自引率
4.40%
发文量
38
审稿时长
28 weeks
期刊最新文献
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