Prescription opioid analgesics for XXXX management in Australia: twenty years of dispensing.

@entity1 @entity1340 @entity1288 @entity2794 @entity158 @entity10425
BACKGROUND: Opioid prescribing/dispensing data can inform policy surrounding regulation by informing trends and types of opioid prescribed and geographic variations. In Australia so far only partial data on dispensing have been published, and data for states/territories remain unknown. AIM: Using a range of measures this study examines 20-year (1992-2011) trends in prescription opioid analgesics in Australia - both nationally and for individual jurisdictions. METHODS: Dispensing data were obtained from the Drug Utilisation Sub-Committee and the Pharmaceutical Benefits Scheme (PBS) websites. Trends in numbers of prescriptions and @entity2794 ( @entity2794 )/1000 @entity1 /day were examined over time, and across states/territories. Seasonal variations in PBS/Repatriation-PBS items for nationwide dispensing were adjusted using a centered moving smoothing technique. RESULTS: In two decades 165.32 million prescriptions for opioid were dispensed, with @entity10425 and its derivatives the most prescribed formulation (50.1%) followed by @entity1340 (13.5%) and @entity1288 derivatives (12.7%). In terms of @entity2794 /1000 @entity1 /day, dispensing increased from 19.87 in 1992 to 55.11 in 2011. There are significant increasing trends for total, PBS/RPBS and under co-payment prescriptions (priced below @entity1 co-payment). The @entity2794 /1000 @entity1 /day for items dispensed through PBS/RPBS was highest in Tasmania. CONCLUSION: Prescription opioid dispensing substantially increased over the study period. With an ageing population this trend is likely to continue in future. A growing concern about harms associated with opioid use warrants balanced control measures so that harms could be minimized without reducing effective @entity158 treatment. Research examining utilisation in small geographic areas may help design spatially tailored interventions. A real-time drug monitoring program may reduce undue prescribing and dispensing.
