A 13-Year National Monitoring Study to Assess Narcotic Prescriptions and Indications (2007–2019)

Perri-Plandé, Joëlle; Miremont-Salamé, Ghada; Micallef, Joëlle; Herman, Cameron; Baumevieille, Marie; Abriat, Frédéric; Lapeyre‐Mestre, Maryse; Haramburu, Françoise; Daveluy, Amélie

doi:10.1007/s40264-021-01124-5

Cited by 7 publications

(1 citation statement)

References 39 publications

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“…A Spanish study showed a 74% increase in IRF prescribing over the period of 2012–2017 (from 3.9 to 6.8 per 10,000 patients). A French study showed an increase of 263% in the prescription of transmucosal fentanyl between 2006 and 2015 and another showed that one-third of the patients in the period 2007–2019 received an off-label transmucosal fentanyl prescription [ 1 , 12 , 26 ]. This indicates that more insight into prevalence, treatment and reasons to prescribe IRF is needed.…”

Section: Discussionmentioning

confidence: 99%

Immediate release fentanyl in general practices: Mostly off-label prescribing

Weesie

Dijk

Bouvy

et al. 2023

European Journal of General Practice

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Background The immediacy of the onset of opioids may be associated with the risk of dependency and accidental overdose. Nasal and oromucosal fentanyl dosage forms are so called immediate release fentanyl (IRF). These IRFs have been approved to treat breakthrough pain in patients with cancer who are on chronic opioid treatment only. There are signals of increased off-label prescribing of IRFs in general practices. Objectives This study aims to provide insight into the frequency of IRF prescription in Dutch general practices and the extent to which IRF is prescribed off-label. Methods Routinely collected electronic health records of general practices (GPs) participating in Nivel Primary Care Database were used. Adult patients with IRF prescriptions in 2019 were selected from whom dispensing data on 2018 and 2019 was available. Diagnoses were recorded by GPs using International Classification of Primary Care. Descriptive analyses were performed. Results This study included 342 GPs with a patient population of 1,297,942 patients, 1,368 patients received at least one IRF prescription in 2019, which is equal to 1.1 patients per 1,000 registered patients. Most patients (74.9%) with an IRF prescription received an off-label prescription. A slight majority had a cancer diagnosis but nearly 65.2% did not have a maintenance therapy and 14% were opioid-naive before receiving their first IRF prescription. Conclusion IRFs are not prescribed frequently in Dutch general practices. However, when prescribed, a relatively large portion of patients received an off-label prescription.

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Section: Discussionmentioning

confidence: 99%