Increasing utilization of strong opioid analgesics in a UK primary care population

• Main Authors: Zin, Che Suraya, Chen, Li-Chia, Knaggs, Roger D
• Format: Conference or Workshop Item
• Language: English
• Published: 2012
• Subjects: RS Pharmacy and materia medica
• Online Access: http://irep.iium.edu.my/35829/1/iasp.pdf; http://irep.iium.edu.my/35829/
• Institution: Universiti Islam Antarabangsa Malaysia

Aims of investigation Studies predominantly conducted in the United States (US) have persistently reported on the increasing trends of opioid utilization which was associated with increasing incidence of dependence and misuse, higher healthcare resources and higher death rate. To date, there are limited data available about the opioid utilization in actual clinical practice in the United Kingdom (UK). This preliminary study aims to evaluate the overall utilization of strong opioid analgesics for the treatment of pain in the UK primary care setting. Methods This cross-sectional study was conducted using the General Practice Research Database (GPRD) which is a large computerized database containing 5 million patients from 639 primary care practices throughout the UK. Data were obtained from patients prescribed a strong opioid-containing drug (buprenorphine, fentanyl, morphine and oxycodone) for pain management from 1st January 2000 to 31st December 2010 by using specific product codes. The total number of prescriptions for each drug during this period was calculated and presented in descriptive statistics. Results The total number of prescriptions for all studied opioid analgesics over the 11 year period was 2.77 million. Morphine was the most frequently prescribed (n=1.39 million, 50%), followed by fentanyl (n=487771, 18%), buprenorphine (n=474869, 17%) and oxycodone (n=424126, 15%). There was also a significant increase in the overall utilization for all studied opioids from year 2000 to 2010. Prescribing of oxycodone increased the most (10960%) compared with buprenorphine (1707%), fentanyl (1135%) and morphine (394%). A rapid increase of buprenorphine prescriptions (479%) were found between 2005 and 2010, compared with oxycodone (202%), fentanyl (129%) and morphine (83%). The most commonly prescribed morphine-containing products were Oramoph® oral solution 10mg/5ml (22%) and MST Continus® tablet 10 mg (14%). For buprenorphine, fentanyl and oxycodone-containing drugs, Butrans® patches 5mcg (14%) and 10 mcg/hour (13%), fentanyl patches 25 mcg (26%) and 50 mcg/hour (18%) and Oxycontin® modified release tablets 10 mg (12%) and 20 mg (10%) were the most commonly prescribed products respectively. Conclusion This preliminary study showed that the overall utilization of strong opioids in the UK has increased significantly in the past eleven years. Further research is required to investigate the association between increased opioids utilisation and adverse outcomes in the UK and to develop future cross-nation comparisons.