Skip to main content
2024 ISPE Annual Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back
Evaluation Video

Oral Presentation

Session: Opioid Odyssey

DARWIN EU® - Trends of prescription opioid use in Europe

Tuesday, August 27, 2024
9:15 AM – 9:30 AM CEST
Location: Room IV
Background: At the request of the European Medicines Agency, we set out to evaluate the trends of prescription opioid use and characterise new opioid users in seven European countries.

Objectives: To evaluate incidence and annual period prevalence of use of opioids and characterise new opioid users.

Methods: We performed a multinational network cohort study, including electronic health records from primary care (CRPD GOLD [UK], SIDIAP [Spain], IPCI [the Netherlands]), primary and outpatient specialist care (IQVIA DA Germany, IQVIA LPD Belgium), hospital care (CHUBX [France]) and Estonian Biobank. All data was standardized to the OMOP Common Data Model. All people registered in a contributing database for ≥365 days between 2012 and 2021 were included. Annual period prevalence (PP) and incidence rates (IR) of opioid prescriptions were estimated and stratified by route of administration, strength and active principle. Long-term trends from 2012 to 2021 were quantified through percent change in PP and IR. New opioid users were characterised, including potential indications.

Results: Between 2012 and 2021, 2,083,893 (CPRD GOLD), 2,023,867 (SIDIAP), 440,849 (IPCI), 207,754 (IQVIA LPD Belgium), 1,248,388 (IQVIA DA Germany), 138,171 (CHUBX) and 53,344 (Estonian Biobank) people received a new opioid prescription. In primary care, incidence of opioid prescriptions decreased between -50.7% (CPRD GOLD) and -2.0% (SIDIAP) from 2012 to 2019, while it increased in Estonian Biobank biobank (+52.8%) and CHUBX hospital data (+25.3%). Prevalence, however, increased in all databases except for IQVIA LPD Belgium and CPRD GOLD.
Opioid use was highest in older adults, and the observed changes in overall opioid use were largely driven by prescriptions of oral opioids. In most databases, new prescriptions of codeine and tramadol decreased over time, while prevalence of oxycodone, morphine, fentanyl, and hydromorphone generally increased. Respiratory conditions (e.g. cough) and pain-related conditions were the most common indications for new opioid prescriptions in the outpatient settings, with complications of procedures and pain being recorded in hospital care. Compared to 2019, the utilization of prescription opioids was consistently lower in 2020 and 2021 across all databases.

Conclusions: Despite a notable decrease in new opioid prescriptions in many European countries, the prevalence of opioid use remained high over the last decade. Potent opioids were more commonly prescribed particularly in the elderly population, rising safety concerns. Continuous monitoring of evolving opioid utilisation patterns will be helpful in the post-pandemic era.