Trends in Israeli community-based opioid prescribing, 2010-2020, an observational study of the country's largest HMO.

Autor: Dressler RL; Clalit Health Services, Department of Family Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem District, HaGitit 64-B, 9839037, Maale Adumim, Israel., Kaliner E; State of Israel Ministry of Health, Central District, 91 Herzl St., 7243003, Ramla, Israel., Cohen MJ; Clalit Health Services, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem District, 1 Ygal Alon St., Bet Shemesh, Israel. Matanc123@gmail.com.
Jazyk: angličtina
Zdroj: Israel journal of health policy research [Isr J Health Policy Res] 2023 Nov 16; Vol. 12 (1), pp. 34. Date of Electronic Publication: 2023 Nov 16.
DOI: 10.1186/s13584-023-00581-w
Abstrakt: Background: Prescription opioids are widely used for pain control and palliative care but have been associated with a variety of untoward effects, including opioid use disorder, addiction, and increased mortality. Patterns of opioid use in Israel are to date poorly described.
Methods: Using a community-based database, the authors performed a retrospective analysis of filled opioid prescriptions of Israeli HMO members 18 years of age or older during the years of 2010-2020 that filled at least one opioid prescription. Morphine milligram equivalent (MME) calculations were stratified by presence or absence of oncology diagnosis and by specific opioid medication.
Results: The percentage of HMO members who filled at least one opioid prescription increased every year from 2.1% in 2010 to 4.2% in 2020. There was an increase in the MME per prescription (44.2%), daily MME per capita (142.1%) and MME per prescription-filling patient (39%) from 2010 to 2020. Increased prescription opioid use is driven by a small group of non-oncological patients, which is less than 1.5% of opioid-prescribed patients and 0.1% of the adult population, primarily owing to fentanyl use.
Conclusion: Supervision and control of opioid prescriptions in Israel should be a focused effort directed at patients prescribed uniquely high dosages rather than a population-wide strategy that focuses on all patients prescribed opioids. This should be complemented by improved physician training and access to non-opioid therapies, as well as improved data collection and analysis.
(© 2023. The Author(s).)
Databáze: MEDLINE
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