Der Gebrauch von Medikamenten mit Abhängigkeitspotenzial in Deutschland

Buth, Sven; Holzbach, Rüdiger; Rosenkranz, Moritz; Verthein, Uwe

doi:10.1007/s00103-017-2571-4

Cited by 15 publications

(19 citation statements)

References 24 publications

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“…The agreement percentage between raters was substantial at 83.3% (Cohen’s kappa = 0.79). Publication dates ranged from 1985 to 2016, six were retrospective cross-sectional studies [8, 40–44] and six were retrospective repeated-measures cross-sectional studies [13–15, 45–47]. The six studies including national data on Germany did not analyse data from the same time period.…”

Section: Resultsmentioning

confidence: 99%

“…Thus, no data overlap happened. Among the five studies analysing data from overlapping periods, two used data from different sources [14, 15], one did not give details of its data source [41] and two may have presented some temporal/geographical overlapping [13, 45]. However, this overlap was considered to broaden the evidence base while bringing validity to the results, so both studies were included in the review respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Sample sizes differed between 92,842 and ≈ 11,000,000. All reviewed studies used secondary data as their main data source: eight studies used health insurance claims data [8, 13, 14, 40, 41, 44, 45, 47], one used prescription data from a pharmacy computing centre [15], one from a disease analyser database [43], one from computerised patient records [42], and one from mixed sources (clinical and market research) [46]. Among the eight publications using health insurance claims records as data source, three obtained their data from BARMER GEK [8, 14, 40], four from regional branches of the AOK [13, 44, 45, 47], and one did not state the name of the statutory health insurance [41].…”

Section: Resultsmentioning

confidence: 99%

“…Six studies investigated the prevalence of opioid use regardless of treatment or opioid class [13–15, 41, 43, 45]. Four studies specifically researched the prevalence of treatment with strong opioids [40, 44, 46, 47].…”

Section: Resultsmentioning

confidence: 99%

“…Their long-term use still remains one of the biggest concerns about opioid treatment, since higher doses and prolonged continuous use increase the probability of adverse effects, habituation and dependence [8–12]. What was seen by some as the unmet need for pain management in chronic pain patients, caused by reluctance to use opioids considering their addiction potential [11, 13–15], has recently become an upsurge in numbers of opioid prescriptions through pharmaceutical market access strategies and policy-making. This is affecting G20 (Group of 20) countries severely and especially so in chronic non-cancer pain (CNCP) patients [12, 16–18].…”

Section: Introductionmentioning

confidence: 99%

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Opioid prescription patterns in Germany and the global opioid epidemic: Systematic review of available evidence

et al. 2019

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Introduction Opioids are one of the most important and effective drug classes in pain medicine with a key role in most medical fields. The increase of opioid prescription over time has led to higher numbers of prescription opioid misuse, abuse and opioid-related deaths in most developed OECD (Organisation for Economic Co-operation and Development) countries around the world. Whilst reliable data on the prevalence of opioid treatment is accessible for many countries, data on Germany specifically is still scarce. Considering Germany being the largest country in the European Union, the lack of evidence-based strategies from long-term studies is crucial. The aim of this work is to review and summarise relevant published literature on the prevalence of opioid prescription in Germany to adequately inform health policy strategies. Methods A systematic review of the epidemiology of opioid prescription in Germany was conducted, searching PubMed and Web of Science. Eligibility criteria were defined prior to conducting the search. Literature concerning Germany, published in English and German was included and the search was replicated by three independent researchers. Two levels of screening were employed. Disagreement was resolved by face-to-face discussion, leading to a consensus judgement. Results Our electronic search yielded 735 articles. Reviewing titles and abstracts yielded 19 relevant articles. Three authors examined each article’s full text more closely and determined that twelve papers should be included. Of the twelve identified studies—with publication dates ranging from 1985 to 2016—six were retrospective cross-sectional studies and six were retrospective repeated-measures cross-sectional studies. Sample sizes ranged from 92,842 to ≈ 11,000,000 participants. Data sources of included studies showed vast heterogeneity. The reviewed literature suggested an increase in the number of patients with opioid prescriptions and defined daily doses of opioids per recipient in Germany over time. The majority of opioid prescriptions was used for patients with non-cancer pain. Opioid use was more common in older people, women and in the north of Germany. Fentanyl was shown to be the most prescribed strong opioid in outpatient settings in Germany, despite not being the first-line choice for chronic pain conditions. All data published before 2000—but none of the more recent studies—suggested an insufficient treatment of pain using opioids. There were no signs for a current opioid epidemic in Germany. Conclusions Despite some limitations of the review and the heterogeneity of studies, it can be stated that the number of opioid prescriptions overall as well as the number of people receiving opioid treatment have increased over time. Most prescriptions were found to be for strong opioids and patients with non-cancer pain. Even though patterns of opioid prescription follow trends observed in other developed countries, there are...

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