Keep your finger on our pulse — latest CAMH news, discoveries and ways to get involved delivered to your inbox. To unsubscribe at any time click the link in our mailing or email: unsubscribe camh. Your donation will fund the groundbreaking mental health research that is helping people on the path to recovery. Please select a newsletter. Please complete the following:.
CAMH Foundation - provides updates on the mental health movement and ways you can get involved. First Name Please input a first name. Last Name Please input a last name. Email Please input an email address. I agree to the Terms of Use for privacy and use of my personal data. Please agree to the Terms of Use. Sign Up. Thanks for Subscribing.
We look forward to keeping you informed, inspired and involved in all things CAMH. Fuel discovery. Save lives. Given that these represent the majority of opioids prescribed across Canada, we do not expect that this exclusion influenced our findings. The findings of this large, nationally representative study of opioid prescription patterns suggest that the introduction of a tamper-deterrent formulation of long-acting oxycodone, against a background of changes in public drug benefit policy, was associated with statistically significant, sustained changes in selection of long-acting opioids but only modest changes in the quantities of long-acting opioids dispensed.
The considerable interprovincial variation shows the added influence of factors such as drug insurance policy and clinical practice on patterns of opioid use. These findings are of high importance given the potential for patient harm when switching between opioids of differing potency, as well as the potential for patients to transition to illicit opioids when access to prescription opioids is restricted.
For reviewer comments and the original submission of this manuscript, please see www. No other competing interests were declared. Tara Gomes and Andrea Mastorakos drafted the article. All of the authors contributed to the conception and design of the study and the interpretation of the data, revised the manuscript critically for important intellectual content, gave final approval of the version to be published and agreed to be accountable for all aspects of the work.
The opinions, results, and conclusions reported in this paper are those of the authors. Disclaimer: The statements, findings, conclusions, views and opinions contained and expressed in this publication are based in part on data obtained under licence from IMS Health Canada Inc. All rights reserved. The statements, findings, conclusions, views and opinions contained and expressed herein are not necessarily those of IMS Health Canada Inc.
Dormuth British Columbia , Brenda R. Hemmelgarn Alberta , Gary F. Henry and J. Platt Methods and Ingrid S. Sketris Knowledge Translation. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Skip to main content. Tara Gomes , Andrea Mastorakos , J. Tara Gomes. Abstract Background: In February , a reformulated tamper-deterrent form of long-acting oxycodone, OxyNeo, was introduced in Canada.
Methods Setting and design We conducted a population-based, repeated cross-sectional analysis of prescribing of long-acting opioids across Canada between May 1, , and Apr.
View this table: View inline View popup. Table 1: Characteristics of opioid formulations included in the study. Sources of data We used the QuintilesIMS CompuScript database to identify monthly quantities of retail pharmacy prescriptions for all eligible opioid analgesics dispensed during the study period.
Outcomes We calculated the total quantity of opioid dispensed each month by multiplying the units by the formulation strength and expressed the quantity in milligrams of morphine equivalents MMEs using conversion ratios reported by the National Opioid Use Guideline Group.
Statistical analysis We used time series analysis to characterize the impact of the introduction of OxyNeo to the provincial drug insurance plan formularies on the rate of dispensing of long-acting and immediate-release opioids in Canada using a ramp function in interventional autoregressive integrated moving average models.
Figure 1 Rate of dispensing of long-acting opioids in milligrams of morphine equivalents [MMEs] per population in Canada, May April , by province. Figure 2 Rate of dispensing of immediate-release opioid dispensing in milligrams of morphine equivalents [MMEs] per population in Canada, May April , by province. Figure 3 Figure 3: Rate of dispensing of long-acting opioids in milligrams of morphine equivalents [MMEs] per population in Canada, May April , by opioid type.
Table 2: Summary of long-acting opioid prescription patterns by province at the beginning and end of the study period. Interpretation In this population-based study spanning 8 years, we found that the introduction of OxyNeo against a background of changes in public drug benefit policy in some Canadian provinces was associated with significant reductions in the quantity of long-acting opioids dispensed, with prescribing of long-acting oxycodone declining dramatically and being partially replaced by increased dispensing of long-acting hydromorphone.
Strengths and limitations A key strength of this study is its capacity to report on quantity of prescribing of long-acting opioids across Canada over an 8-year period. Conclusion The findings of this large, nationally representative study of opioid prescription patterns suggest that the introduction of a tamper-deterrent formulation of long-acting oxycodone, against a background of changes in public drug benefit policy, was associated with statistically significant, sustained changes in selection of long-acting opioids but only modest changes in the quantities of long-acting opioids dispensed.
Supplemental information For reviewer comments and the original submission of this manuscript, please see www. CMAJ : — Addiction : — 8. International Narcotics Control Board Opioid consumption motion chart. J Pain Palliat Care Pharmacother 25 : 6 — World Health Organization population data.
Available www. Chronic Dis Inj Can 31 : — OpenUrl PubMed. CMAJ : — 6. Am J Public Health 99 : — 7. J Pain Palliat Care Pharmacother 17 : 1 — 4. Steffan RR Timed-release oxycodone. Can Fam Physician 59 : — 3. Environmental Scan; Issue Can Fam Physician 60 : — Fischer B , Jones W , Rehm J Trends and changes in prescription opioid analgesic dispensing in Canada an update with a focus on recent interventions.
Michael's Hospital, Toronto, Ontario, Canada,. All analyses were reported nationally and stratified by province. By April , Opioids are a class of drugs that have been traditionally used to treat acute and chronic pain. Since this time, policies have been introduced across Canada to address the rising use of oxycodone and its potential for misuse. These have included restricted access on some provincial drug programs and the introduction of safety warnings on product monographs.
This database provides projections for prescription quantities at the provincial and national level based on data captured from a representative sample of approximately community pharmacies across the country. The geographic location of pharmacies, the distance between pharmacies and pharmacy size are all incorporated into projections, which are conducted by QuintilesIMS at the level of drug identification number.
The quality of these data is continuously monitored and verified by QuintilesIMS, and the Compuscript database is regularly used for research purposes. A total of This fall was seen in most provinces but was variable, ranging from There was no apparent rebound in dispensing after the introduction of generic forms in late Figure 1. October to April Provinces listed with approximate population as name average population in millions over the study period.
BC: British Columbia 4. December to April In Quebec, there was rapid uptake of this formulation between February and April , after which the prevalence of generic dispensing remained relatively stable until another rise occurred in early Overall, the prevalence of generic dispensing reached However, we did observe considerable variation in the market shares achieved by the generic forms across the Canadian provinces.
This suggests that public drug funding and restricted reimbursement criteria influenced broad patterns of oxycodone use across Canada. However, these products have a relatively low cost, which might not deter their use in cases where a patient is prescribed the product by their physician but do not meet coverage criteria by a public or private drug insurance plan.
Similarly, in British Columbia, the provincial drug formulary reimbursed the generic form until February when it was announced that the PharmaCare program would no longer cover these products. However, several limitations warrant emphasis. Finally, we are not able to distinguish between publicly and privately funded ie, cash paid or privately insured prescriptions. The geographic variation in uptake of these products suggests that provincial drug reimbursement policies—including restrictions on access through public drug formularies—has influenced these trends.
No other authors report any competing interests.
0コメント