Abstract
OBJECTIVES: The COVID-19 pandemic and related lockdown measures disrupted global healthcare provision, including opioid prescribing. In North America, opioid sales declined while opioid-related deaths increased. In Europe, the effect of the pandemic on prescribing is not yet known. Given the ongoing increase in opioid-related harm and mortality, it is crucial to analyse the impact of the COVID-19 crisis and lockdown measures on opioid prescribing. Therefore, the objective of this study was to characterise opioid prescribing in the Netherlands during the COVID-19 pandemic.
DESIGN: A nationwide register-based study characterising opioid prescribing using aggregated insurance reimbursement data.
SETTING: Dutch healthcare during the first 2 years of the COVID lockdown.
PARTICIPANTS: The whole Dutch population.
PRIMARY AND SECONDARY OUTCOME MEASURES: Comparing the number of opioid prescriptions during the pandemic with a prepandemic period using a risk ratio (RR), with separate analysis on the prescription type (first-time or repeat prescription), patients' sex, age and socioeconomic status. We also explored lockdown effects.
RESULTS: During the first lockdown, the total number of new opioid prescriptions and prescriptions to young patients (briefly) decreased (RR 0.88, 95% CI 0.88 to 0.89 and RR 0.73, 95% CI 0.70 to 0.75, respectively), but the overall number of opioid prescriptions remained stable throughout the pandemic compared with prepandemic. Women, older patients and patients living in lower socioeconomic areas received more opioids per capita, but the pandemic did not amplify these differences.
CONCLUSIONS: The pandemic appears to have had a limited impact on opioid prescribing in the Netherlands. Yet, chronic use of opioids remains an important public health issue.
| Original language | English |
|---|---|
| Article number | e082369 |
| Number of pages | 24 |
| Journal | BMJ Open |
| Volume | 14 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 3 Aug 2024 |
Bibliographical note
Publisher Copyright:© Author(s) (or their employer(s)) 2024.
Funding
This work is part of the research project Tackling and Preventing the Opioid Epidemic (TAPTOE) and received funding from the Dutch Research Council (Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO)) in the framework of the NWA-ORC Call (NWA.1160.18.300). The views expressed in this paper are those of the authors and do not necessarily reflect the views or policies of the NWO. The NWO is not liable for any use that may be made of the information presented. The Dutch National Healthcare Institute (Zorginstituut Nederland) provided data and technical support as an in-kind contribution for the study. The authors thank the Dutch National Healthcare Institute (Zorginstituut Nederland), specifically Saskia Knies and Ilo Boukes, for providing and preparing the data analysed in this study and for their technical support. This work is part of the research project Tackling and Preventing the Opioid Epidemic (TAPTOE) and received funding from the Dutch Research Council (Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO)) in the framework of the NWA-ORC Call (NWA.1160.18.300). The views expressed in this paper are those of the authors and do not necessarily reflect the views or policies of the NWO. The NWO is not liable for any use that may be made of the information presented. The Dutch National Healthcare Institute (Zorginstituut Nederland) provided data and technical support as an in-kind contribution for the study.
| Funders | Funder number |
|---|---|
| Nederlandse Organisatie voor Wetenschappelijk Onderzoek | |
| NWA-ORC | |
| Saskia Knies and Ilo Boukes | |
| Dutch National Healthcare Institute |
Keywords
- Adolescent
- Adult
- Aged
- Analgesics, Opioid/therapeutic use
- COVID-19/epidemiology
- Child
- Drug Prescriptions/statistics & numerical data
- Female
- Humans
- Male
- Middle Aged
- Netherlands/epidemiology
- Pandemics
- Practice Patterns, Physicians'/statistics & numerical data
- Registries
- SARS-CoV-2
- Young Adult
