Harmonizing Post-Market Surveillance of Prescription Drug Misuse: A Systematic Review of Observational Studies Using Routinely Collected Data (2000–2013)

Blanch, Bianca; Buckley, Nicholas A.; Mellish, Leigh; Dawson, Andrew; Haber, Paul S.; Pearson, Sallie‐Anne

doi:10.1007/s40264-015-0294-8

Cited by 17 publications

(30 citation statements)

References 94 publications

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“…In recent decades, the growing availability of routinely collected data on prescribed and dispensed prescription drugs in many countries has substantially increased the opportunities to undertake research aimed at investigating patterns of drug use in the population (69,(109)(110)(111).…”

Section: Pharmacoepidemiological Methods In Studies Of Psychoactive Pmentioning

confidence: 99%

“…Measurements based on individual-level prescription or dispensing data typically aim at identifying behaviours typical of drug addiction and drug abuse, such as substance seeking behaviour (including doctor shopping) and the use of large volumes of drug (9)(10)(11)69 Thus, this research area is still in its infancy (69,70). In particular, there is a lack of validated and standardised measurements that identify and separate prescription drug misuse and abuse (69).…”

Section: Pharmacoepidemiological Methods In Studies Of Psychoactive Pmentioning

confidence: 99%

“…In research, due to lack of sufficient clinical information it is generally difficult to establish a drug use disorder (69,70). In study II of this thesis, the DSM-IV criteria of substance dependence were assessed, which are equal, but not identical, to the current DSM-5 criteria for mild substance use disorder.…”

Section: Psychoactive Prescription Drug Use Disordersmentioning

confidence: 99%

“…A consequence of addiction is the irrational use of these drugs, which may occur at several stages of the drug use process. At the level of the individual patient (or drug user) addiction is typified by the use of excessive and gradually increasing doses, overdosing, use of non-prescribed drugs, multiple substance use, substance-seeking behaviour and tampering, the manifestation of which shows large variation between individuals and over time (69)(70)(71)(72)(73)(74). This misuse of psychoactive medications also involves diversion and counterfeit production (for definitions, see Terminology).…”

Section: Psychoactive Prescription Drug Misuse and Abusementioning

confidence: 99%

“…The terms used to describe this irrational drug use range widely as a result of the various manifestations of the misuse (69)(70)(71)(72)(73)(74), discrepancies in the two major diagnostic systems (5,68) and a lack of standard terminology and methodology. (17,18).…”

Section: Psychoactive Prescription Drug Misuse and Abusementioning

confidence: 99%

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Psychoactive prescription drug use disorders, misuse and abuse : Pharmacoepidemiological aspects

Tjäderborn

2016

Linköping University Medical Dissertations

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Background: There is a widespread and increasing use of psychoactive prescription drugs, such as opioid analgesics, anxiolytics, hypnotics and anti-epileptics, but their use is associated with a risk of drug use disorder, misuse and abuse. Today, these are globally recognised and emerging public health concerns. Aim:The aim of this thesis is to estimate the occurrence and prevalence of psychoactive prescription drug use disorders, misuse and abuse, and to investigate the association with some potential risk factors. Methods:A study using register data from forensic cause of death investigations analysed and described cases of fatal unintentional intoxications with tramadol (Study I). Based on register data on spontaneously reported adverse drug reactions (ADRs) reported cases of tramadol dependence were scrutinized and summarised (Study II). In a study in suspected drug-impaired drivers with a toxicology analysis confirming intake of tramadol, diazepam, flunitrazepam, zolpidem and zopiclone, the prevalence of non-prescribed use was assessed and associated factors were investigated (Study III). From a national cohort of patients initiating prescribed treatment with pregabalin, identified using data on prescription fills, a study investigated longitudinal utilisation patterns during five years with regards to use above the maximum approved daily dose (MAD) of the drug, and factors associated with the utilisation patterns (Study IV).Results: In the first study, 17 cases of unintentional intoxications were identified, in which tramadol was judged to have caused or contributed to the death. Of the deceased, more were men, the median age was 44 years and the majority used multiple psychoactive substances (prescription drugs, alcohol and/or illicit drugs). In the second study, 104 spontaneously vi reported cases of possible or probable tramadol dependence were identified, of which more concerned women. The median age in these cases was 45 years and in about a third of cases the person had a history of substance abuse and in 40% of cases there was documented history of psychoactive medication use. Severe addiction was reported. In the third study, more than half of the individuals suspected of drug-impaired driving used the drug without a recent prescription.Non prescribed use was most frequent in users of benzodiazepines and of tramadol compared to users of zolpidem or zopiclone, and was more likely in younger individuals and in multiplesubstance users and less likely in individuals with a recent prescription for another psychoactive medication. In the last paper, five longitudinal utilisation patterns were found in pregabalin users, with two patterns associated with a particularly high risk of use of doses above the maximum approved daily dose. The highest risk of use of daily doses above the MAD over time was associated with male sex, younger age, non-urban residency, and a recent prescribed treatment with an antiepileptic or opioid analgesic drug. Conclusions

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Section: Pharmacoepidemiological Methods In Studies Of Psychoactive Pmentioning

confidence: 99%

Section: Pharmacoepidemiological Methods In Studies Of Psychoactive Pmentioning

confidence: 99%

Section: Psychoactive Prescription Drug Use Disordersmentioning

confidence: 99%

Section: Psychoactive Prescription Drug Misuse and Abusementioning

confidence: 99%

Section: Psychoactive Prescription Drug Misuse and Abusementioning

confidence: 99%

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Psychoactive prescription drug use disorders, misuse and abuse : Pharmacoepidemiological aspects

Tjäderborn

2016

Linköping University Medical Dissertations

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Core concepts in pharmacoepidemiology: Measures of drug utilization based on individual‐level drug dispensing data

Rasmussen

Wettermark

Steinke

et al. 2022

Pharmacoepidemiology and Drug

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Background Drug utilization studies are essential to facilitate rational drug use in the society. Aim In this review, we provide an overview of drug utilization measures that can be used with individual‐level drug dispensing data, referencing additional reading on the individual analysis. This is intended to serve as a primer for those new to drug utilization research and a shortlist from which researchers can identify useful analytical approaches when designing their drug utilization study. Results and Discussion We provide an overview of: (1) basic measures of drug utilization which are used to describe changes in drug use over time or compare drug use in different populations; (2) treatment adherence measures with specific focus on persistence and implementation; (3) how to measure drug combinations which is useful when assessing drug–drug interactions, concomitant treatment, and polypharmacy; (4) prescribing quality indicators and measures to assess variations in drug use which are useful tools to assess appropriate use of drugs; (5) proxies of prescription drug misuse and skewness in drug use; and (6) considerations when describing the characteristics of drug users or prescribers.

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A Review of the Opioid Epidemic: What Do We Do About It?

2018

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The opioid epidemic, with its noticeable increase in opioid prescriptions and related misuse, abuse and resultant deaths in the previous 12 years, is a particularly North American phenomenon. Europe, and particularly low- and middle-income countries, appear to be less influenced by this problem. There is undisputable value in using opioids not only in the treatment of acute pain, but in cancer pain as well. However, opioids are progressively being prescribed more and more for chronic non-cancer pain, despite inadequate data on their efficacy. In this paper, we describe the current prevalence of opioid misuse in a number of countries and the rationale for the commencement of opioid therapy. The safe initiation and monitoring of opioid therapy as well as the need for concurrent use of interdisciplinary multimodal therapy is discussed. The possible consequences of long-term use and predictors of high opioid use and overdose are presented. In particular, the management of opioid use disorders and the prevention of opioid abuse and dependence in the young, the old and the pregnant are discussed. Measures to prevent overprescribing and to alleviate risk are described, including the tapering of opioids and the use of opioid deterrents. Finally, the paper looks at the future development of pioneering medications and technologies to potentially treat abuse. In those parts of the world with an opioid epidemic, coroners and medical examiners, private and public health agencies, and agencies that enforce the law need to cooperate in an effort to slow down and reverse the indiscriminate use of prescribing opioids in the long-term for chronic non-cancer pain. Ongoing research is needed to create ways to minimise risks of opioid use, and to provide evidence for effective strategies for treating chronic pain.

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Harmonizing Post-Market Surveillance of Prescription Drug Misuse: A Systematic Review of Observational Studies Using Routinely Collected Data (2000–2013)

Cited by 17 publications

References 94 publications

Psychoactive prescription drug use disorders, misuse and abuse : Pharmacoepidemiological aspects

Psychoactive prescription drug use disorders, misuse and abuse : Pharmacoepidemiological aspects

Core concepts in pharmacoepidemiology: Measures of drug utilization based on individual‐level drug dispensing data

A Review of the Opioid Epidemic: What Do We Do About It?

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