Analgesic switching in chronic users of dextropropoxyphene in France

IF 2.1 4区医学 Q3 PHARMACOLOGY & PHARMACY Fundamental & Clinical Pharmacology Pub Date : 2023-10-21 DOI:10.1111/fcp.12962

Amélie Daveluy, Michael Charles Bryan, Ghada Miremont-Salamé, Régis Lassalle, Clémentine Lacueille, Angela Grelaud, Marie Floccia, Françoise Haramburu, Maryse Lapeyre-Mestre, Joëlle Micallef, Francesco Salvo

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Abstract

Background

The combination dextropropoxyphene/paracetamol (DXP/P) was the most prescribed opioid analgesic until its withdrawal in 2011.

Objectives

This study investigated dispensations of analgesics in chronic users of DXP/P during the 18 months following its withdrawal.

Methods

A cross-sectional study repeated yearly was conducted by using the French reimbursement database from 2006 to 2015. Chronic DXP/P users were defined as patients who received at least 40 boxes of DXP/P in the year prior to withdrawal. Data on analgesic dispensing were analyzed at DXP/P withdrawal (T0) and then every 6 months for 18 months.

Results

A total of 63 671 subjects had a DXP/P reimbursement in the year prior to its discontinuation, of whom 7.1% were identified as chronic users (mean age: 71.5 years, women: 68.7%). Among the patients taking DXP/P alone at T0 (74.6%), one fourth switched to a peripheral analgesic, one fourth to a combination of peripheral analgesic/opioid, one fourth to another opioid, and the others mainly discontinued their treatment (14.1%) or died. During the following 12 months, most of the subjects taking only peripheral analgesics continued this treatment, while half of the subjects with a combination of opioid/peripheral analgesic or taking only an analgesic remained on this type of treatment.

Conclusion

Eighteen months after DXP/P withdrawal, more than 10% of patients stopped taking an analgesic. Vigilance is required regarding any change in analgesics by regularly reassessing patients' pain and, in the case of opioid treatments, by monitoring the risk of use disorders.

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法国右丙氧芬慢性使用者的镇痛转换。

背景：右丙氧基苯/对乙酰氨基酚（DXP/P）是处方最多的阿片类止痛药，直到2011年停用退出后数月。方法：从2006年到2015年，使用法国报销数据库每年重复进行一次横断面研究。慢性DXP/P使用者被定义为在停药前一年至少接受40盒DXP/P的患者。在DXP/P停药（T0）时分析镇痛药分配数据，然后每6次分析一次 18个月月。结果：共63 671名受试者在停药前一年获得了DXP/P报销，其中7.1%被确定为慢性使用者（平均年龄：71.5岁，女性：68.7%），其余主要为停药（14.1%）或死亡。在接下来的12 几个月后，大多数只服用外周镇痛药的受试者继续接受这种治疗，而一半同时服用阿片类药物/外周镇痛剂或只服用镇痛药的被试者仍在接受这种治疗。结论：DXP/P停药18个月后，超过10%的患者停止服用镇痛药。需要对止痛药的任何变化保持警惕，定期重新评估患者的疼痛，在阿片类药物治疗的情况下，监测使用障碍的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fundamental & Clinical Pharmacology 医学-药学

CiteScore

5.30

自引率

6.90%

发文量

111

审稿时长

6-12 weeks

期刊介绍： Fundamental & Clinical Pharmacology publishes reports describing important and novel developments in fundamental as well as clinical research relevant to drug therapy. Original articles, short communications and reviews are published on all aspects of experimental and clinical pharmacology including: Antimicrobial, Antiviral Agents Autonomic Pharmacology Cardiovascular Pharmacology Cellular Pharmacology Clinical Trials Endocrinopharmacology Gene Therapy Inflammation, Immunopharmacology Lipids, Atherosclerosis Liver and G-I Tract Pharmacology Metabolism, Pharmacokinetics Neuropharmacology Neuropsychopharmacology Oncopharmacology Pediatric Pharmacology Development Pharmacoeconomics Pharmacoepidemiology Pharmacogenetics, Pharmacogenomics Pharmacovigilance Pulmonary Pharmacology Receptors, Signal Transduction Renal Pharmacology Thrombosis and Hemostasis Toxicopharmacology Clinical research, including clinical studies and clinical trials, may cover disciplines such as pharmacokinetics, pharmacodynamics, pharmacovigilance, pharmacoepidemiology, pharmacogenomics and pharmacoeconomics. Basic research articles from fields such as physiology and molecular biology which contribute to an understanding of drug therapy are also welcomed.