Trends and correlated outcomes in population-level prescription opioid and transdermal fentanyl use in Israel.

IF 3.5 4区 医学 Q1 HEALTH POLICY & SERVICES Israel Journal of Health Policy Research Pub Date : 2023-03-20 DOI:10.1186/s13584-023-00558-9
Barak Shapira, Ronny Berkovitz, Ziona Haklai, Nehama Goldberger, Irena Lipshitz, Paola Rosca
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引用次数: 2

Abstract

Background: In the last twenty years, there was a documented increase in prescription opioid procurement in Israel. However, there is still little evidence of the association between opioid procurement rates, health service utilisation in secondary care, and enrollment rates to substance use disorder treatment programmes. In this study, we show trends in the reports of opioid-related hospitalisations, emergency department visits, enrollment to community-based outpatient treatment for Prescription Opioid Use Disorder and opioid-related mortality rates. Additionally, we examine potential correlations between these health service utilisation rates and prescription opioid procurement rates at the population level, with a focus on transdermal fentanyl.

Methods: A longitudinal study at the population level. We used seven-year data on indicators of opioid-related morbidity, prescription opioid procurement data for 2015-2021, and six-year opioid-related mortality data for 2015-2020. We measure the correlation between procurement rates of prescription opioids in Oral Morphine Equivalent per capita, and aggregated rates obtained from hospital administrative data for hospitalisations, emergency department visits, and patient enrolment in specialised prescription opioid use disorder outpatient treatment in the community setting.

Results: Between 2015 and 2021, procurement rates in primary care per capita for all prescription opioids increased by 85%, while rates of transdermal fentanyl procurement increased by 162%. We found a significant positive correlation at the population level, between annual opioid procurement rates, and rates per population of opioid-related visits to emergency departments (r = 0.96, p value < 0.01, [CI 0.74-0.99]), as well as a positive correlation with the rates per population of patient enrolment in specialised prescription opioid use disorder outpatient treatment (r = 0.93, p value = 0.02, [CI 0.58-0.99]). Opioid-related mortality peaked in 2019 at 0.31 deaths per 100,000 but decreased to 0.20 deaths per 100,000 in 2020.

Conclusion: Data shows that all-opioid and transdermal fentanyl procurement has increased yearly between 2015 and 2021. This increase is positively correlated with a growing demand for community-based Prescription Opioid Use Disorder outpatient treatment. Efforts to reduce opioid-related morbidity may require effective approaches toward appropriate prescribing, monitoring, and further increasing access to prescription opioid outpatient treatment.

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以色列人口水平处方阿片类药物和透皮芬太尼使用的趋势和相关结果
背景:在过去的二十年中,以色列的处方阿片类药物采购有所增加。然而,仍然很少有证据表明阿片类药物采购率、二级保健中的卫生服务利用率和药物使用障碍治疗方案的入学率之间存在关联。在本研究中,我们展示了阿片类药物相关住院、急诊就诊、处方阿片类药物使用障碍社区门诊治疗登记和阿片类药物相关死亡率报告的趋势。此外,我们在人口水平上研究了这些卫生服务利用率与处方阿片类药物采购率之间的潜在相关性,重点是透皮芬太尼。方法:在人口水平上进行纵向研究。我们使用了阿片类药物相关发病率指标的7年数据、2015-2021年阿片类药物处方采购数据和2015-2020年6年阿片类药物相关死亡率数据。我们测量了口服吗啡当量中处方阿片类药物的人均购买率与从住院、急诊就诊和社区环境中专门处方阿片类药物使用障碍门诊治疗的医院行政数据中获得的总比率之间的相关性。结果:2015年至2021年间,所有处方阿片类药物的人均初级保健采购率增加了85%,而透皮芬太尼采购率增加了162%。我们发现,在人口水平上,阿片类药物的年度采购率与阿片类药物相关的急诊就诊率之间存在显著的正相关(r = 0.96, p值)。结论:数据显示,2015年至2021年间,全阿片类药物和透皮芬太尼的采购量逐年增加。这一增长与社区处方阿片类药物使用障碍门诊治疗需求的增长呈正相关。努力减少阿片类药物相关的发病率可能需要有效的方法,以适当的处方,监测,并进一步增加获得处方阿片类药物门诊治疗。
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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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