| Title |
Person-level changes in oxycodone use after the introduction of a tamper-resistant formulation in Australia
|
|---|---|
| Published in |
Canadian Medical Association Journal, March 2018
|
| DOI | 10.1503/cmaj.170666 |
| Pubmed ID | |
| Authors |
Andrea L Schaffer, Nicholas A Buckley, Louisa Degenhardt, Briony Larance, Rose Cairns, Timothy A Dobbins, Sallie-Anne Pearson |
| Abstract |
Australia introduced tamper-resistant controlled-release (CR) oxycodone in April 2014. We quantified the impact of the reformulation on dispensing, switching and poisonings. We performed interrupted time-series analyses using population-representative national dispensing data from 2012 to 2016. We measured dispensing of oxycodone CR (≥ 10 mg), discontinuation of use of strong opioids and switching to other strong opioids after the reformulation compared with a historical control period. Similarly, we compared calls about intentional opioid poisoning using data from a regional poisons information centre. After the reformulation, dispensing decreased for 10-30 mg (total level shift -11.1%, 95% confidence interval [CI], -17.2% to -4.6%) and 40-80 mg oxycodone CR (total level shift -31.5%, 95% CI -37.5% to -24.9%) in participants less than 65 years of age but was unchanged in people 65 years of age or older. Compared with the previous year, discontinuation of use of strong opioids did not increase (adjusted hazard ratio [HR] 0.95, 95% CI 0.91 to 1.00), but switching to oxycodone/naloxone did increase (adjusted HR 1.54, 95% CI 1.32 to 1.79). Switching to morphine varied by age (p < 0.001), and the greatest increase was in participants less than 45 years of age (adjusted HR 4.33, 95% CI 2.13 to 8.80). Participants switching after the reformulation were more likely to be dispensed a tablet strength of 40 mg or more (adjusted odds ratio [OR] 1.40, 95% CI 1.09 to 1.79). Calls for intentional poisoning that involved oxycodone taken orally increased immediately after the reformulation (incidence rate ratio (IRR) 1.31, 95% CI 1.05-1.64), but there was no change for injected oxycodone. The reformulation had a greater impact on opioid access patterns of people less than 65 years of age who were using higher strengths of oxycodone CR. This group has been identified as having an increased risk of problematic opioid use and warrants closer monitoring in clinical practice. |
X Demographics
The data shown below were collected from the profiles of 10 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 4 | 40% |
| United States | 3 | 30% |
| United Kingdom | 1 | 10% |
| Unknown | 2 | 20% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 50% |
| Practitioners (doctors, other healthcare professionals) | 4 | 40% |
| Science communicators (journalists, bloggers, editors) | 1 | 10% |
Mendeley readers
The data shown below were compiled from readership statistics for 33 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 33 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 4 | 12% |
| Student > Master | 4 | 12% |
| Student > Ph. D. Student | 2 | 6% |
| Student > Doctoral Student | 2 | 6% |
| Student > Bachelor | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 19 | 58% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 18% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 6% |
| Psychology | 2 | 6% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Agricultural and Biological Sciences | 1 | 3% |
| Other | 3 | 9% |
| Unknown | 18 | 55% |
Attention Score in Context
This research output has an Altmetric Attention Score of 63. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 May 2018.
All research outputs
#594,024
of 23,305,591 outputs
Outputs from Canadian Medical Association Journal
#980
of 8,849 outputs
Outputs of similar age
#15,049
of 331,924 outputs
Outputs of similar age from Canadian Medical Association Journal
#31
of 127 outputs
Altmetric has tracked 23,305,591 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,849 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 33.3. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 331,924 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 127 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 76% of its contemporaries.