Trends in Postoperative Opioid Use in Norway 2011–2018: A Nationwide Registry-Based Study
Corresponding Author
Per-Jostein Samuelsen
Regional Medicines Information and Pharmacovigilance Centre (RELIS), University Hospital of North Norway, Tromsø, Norway
Correspondence:
Per-Jostein Samuelsen ([email protected])
Search for more papers by this authorVidar Hjellvik
Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
Search for more papers by this authorIngvild Odsbu
Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
Search for more papers by this authorAudun Stubhaug
Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
Department of Clinical Medicine, University of Oslo, Oslo, Norway
Search for more papers by this authorSvetlana Skurtveit
Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
Search for more papers by this authorSara Magelssen Vambheim
Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
Department of Clinical Medicine, University of Oslo, Oslo, Norway
Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
Search for more papers by this authorCorresponding Author
Per-Jostein Samuelsen
Regional Medicines Information and Pharmacovigilance Centre (RELIS), University Hospital of North Norway, Tromsø, Norway
Correspondence:
Per-Jostein Samuelsen ([email protected])
Search for more papers by this authorVidar Hjellvik
Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
Search for more papers by this authorIngvild Odsbu
Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
Search for more papers by this authorAudun Stubhaug
Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
Department of Clinical Medicine, University of Oslo, Oslo, Norway
Search for more papers by this authorSvetlana Skurtveit
Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
Search for more papers by this authorSara Magelssen Vambheim
Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
Department of Clinical Medicine, University of Oslo, Oslo, Norway
Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
Search for more papers by this authorFunding: P.-J.S. was partly funded by a personal grant from the Northern Norway Regional Health Authority (Helse Nord HNF1610-21). S.M.V. was funded by the Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway. S.O.S., I.O. and V.H. were partly funded by the Research Council of Norway (320360). The authors were otherwise funded by their respective institutions.
ABSTRACT
Little is known about the overall trends in postoperative opioid use in a Nordic setting. We investigated the trends in Norway between 2011 and 2018. We linked the Norwegian Prescription Database, the Norwegian Patient Registry, the Cancer Registry of Norway and the Cause of Death Registry. Postoperative opioid use was defined as the first opioid dispensing per year within 14 days of a NOMESCO Classification of Surgical Procedure code. We excluded patients with cancer or opioid maintenance therapy. We calculated period prevalence (Norwegian population ≥ 15 years as the denominator), substance distribution, initial amount and proportion of long-acting formulations. Among 746 435 postoperative opioid users ≥ 15 years, the period prevalence increased from 27.0/1000 in 2011 to 30.0/1000 in 2018 (long-term use: 2.0 to 3.3/1000). Codeine was most frequent (67%) in 2011, while codeine and tramadol were equally dispensed (41% and 43%) in 2018; oxycodone increased from 3% to 12%. The initial amount increased for opioids as a group but declined for oxycodone (1236 morphine milligram equivalents [MME]/patient to 914 MME/patient) and tramadol (233 MME/patient to 219 MME/patient). Long-acting depot formulations increased from 5% to 12%. Over time, postoperative opioid use increased, with a shift toward more tramadol and oxycodone in lower initial amounts, and increased use of long-acting formulations.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The cohort is derived from individual-level data from national health and population registries. The authors are not allowed, by law, to publicly share these data. Therefore, the authors cannot make these data fully available to the public. The authors may share statistical code.
Supporting Information
Filename | Description |
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bcpt70040-sup-0001-supplement.docxWord 2007 document , 272 KB |
Figure S1 Study design diagram. Table S1 Chapter names of the Nordic Medico-Statistical Committee Classification of Surgical Procedures (NCSP). Table S2 Characteristics of the study population stratified by calendar year. Table S3 Period prevalence of postoperative opioid use per 1000 inhabitants, stratified by short-term and long-term use, 2011–2018. Figure S2 Mean amount of dispensed opioids per patient at index date in MME (right y-axis, purple) or DDDs (left y-axis, green) for the years 2011–2018, stratified by short-term (dashed lines) and long-term use (solid lines). Table S4 Initial amount expressed as MME per patient, stratified by calendar year, age groups and substance. Table S5 Distribution of administration forms of the opioid dispensings per year, %. Table S6 Prevalence of postoperative opioid use per 1000 inhabitants, stratified by calendar year, duration, sex and age groups. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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