Increase in Opiate Prescription in Germany Between 2000 and 2010: A Study Based on Insurance Data.
Increase in opiate prescription in Germany between 2000 and 2010: a study based on insurance data.
Dtsch Arztebl Int. 2013 Jan; 110(4): 45-51
Schubert I, Ihle P, Sabatowski R
Insufficient data have been available to date on the prevalence of opioid treatment in Germany, physicians’ prescribing habits, and the percentages of cancer patients and non-cancer patients among those receiving opioids for an evaluation of the quality of care and an assessment of possible underuse or misuse.The data analyzed in this study were derived from the statutory health insurance sample of the AOK health insurance company in the German state of Hesse / ASHIP Hesse for the years 2000-2010. For the purpose of this study, prevalence was defined as the percentage of insurees who received at least one outpatient prescription of an opioid (ATC N02A, excluding codeine, levomethadone and methadone). In order to control for population aging, the prevalence was standardized to the German population on December 31(st) of the preceding year and to the age-structure of the population as it was in 1999. Opioid prescribing for cancer was assumed when a cancer diagnosis was documented in the same year in which the opioid prescription was issued.The percentage of insurees receiving at least one opioid prescription rose over the period of the study from 3.31% in 2000 to 4.53% in 2010, a relative gain of 37%. Opioids were mostly prescribed to patients with non-cancer pain (2010: about 77% of opioid recipients). The percentage of non-cancer patients receiving long-term opioid treatment has also increased over the period of the study.As opioids are frequently prescribed for non-cancer pain, it cannot be inferred from the observed increase in opioid prescribing that cancer patients are now receiving better opioid treatment than they were before. Further issues of concern are the observed increases in the prescribing of potent immediate release opioids and in the long-term opioid treatment for non-cancer patients, the benefit of which is currently debated.
HubMed – Methadone
A Randomized Controlled Trial to Evaluate the Relative Efficacy of the Addition of a Psycho-Social Intervention to Standard-of-Care Services in Reducing Attrition and Improving Attendance Among First-Time Users of Methadone Maintenance Treatment in China.
AIDS Behav. 2013 Feb 15;
Gu J, Lau JT, Xu H, Zhong Y, Hao Y, Zhao Y, Fan L, Ling W
Although methadone maintenance treatment (MMT) is an important means of HIV control, MMT clinics commonly have high attrition rates. The randomized controlled trial investigated the relative efficacy of adding a psycho-social intervention to the standard-of-care MMT in reducing attrition and non-attendance among first-time newly admitted MMT users in China (n = 288). Social workers implemented this three-phase intervention that was based on a behavioral maintenance theory. It also involved participants’ family members and rectified some MMT-related misconceptions. As compared to the control group, the intervention group showed significantly lower likelihood of attrition (HR = 0.55, 95 % confidence interval 0.39-0.80), lower estimated probability of attrition at Month 12 (0.35 vs. 0.55), and higher median number of days of attendance (Month 6: 147 vs. 91 days, p < 0.001; end-date: 225 vs. 142 days, p < 0.001). Further psycho-social services and translational research are warranted. HubMed – Methadone
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