Journal article
Community Opioid Dispensing after Injury (CODI): Cohort characteristics and opioid dispensing patterns
Injury, Vol.55(3), pp.1-8
2024
Abstract
Background:
Despite a focus of opioid-related research internationally, there is limited understanding of long-term opioid use in adults following injury. We analysed data from the ‘[Blinded]’ data linkage study.
Aims:
This paper aims to describe the baseline characteristics of the injured cohort and report opioid dispensing patterns following injury-related hospitalisations.
Methods:
Retrospective cohort study of adults hospitalised after injury (ICD-10AM: S00-S99, T00-T75) in Queensland, Australia between 1 January 2014 and 31 December 2015, prior to implementation of opioid stewardship programs. Data were person-linked between hospitalisation, community opioid dispensing and mortality collections. Data were extracted for 90-days prior to the index hospital admission, to establish opiate naivety, to 720 days after discharge. Median daily oral morphine equivalents (i.e., dose) were averaged for each 30-day interval. Cumulative duration of dispensing and dose were compared by demographic and clinical characteristics, stratified by drug dependency status.
Results:
Of the 129,684 injured adults, 61.3% had no opioids dispensed in the 2-year follow-up period. Adults having any opioids dispensed in the community (38.7%) were more likely older, female, to have fracture injuries and injuries with a higher severity, compared to those with no opioids dispensed. Longer durations and higher doses of opioids were seen for those with pre-injury opioid use, more hospital readmissions and repeat surgeries, as well as those who died in the 2-year follow-up period. Median dispensing duration was 24-days with a median daily end dose of 13 oral morphine equivalents. If dispensing occurred prior to the injury, duration increased 10-fold and oral morphine equivalents doubled. Adults with a documented dependency prior to, or after, the injury had significantly longer durations of use and higher doses than the rest of the cohort receiving opioids. Approximately 7% of the total cohort continued to be dispensed opioids at 2-years post injury.
Conclusion:
This is a novel population-level profile of opioid dispensing patterns following injury-related hospitalisation, described for the time period prior to the implementation of opioid stewardship programs and regulatory changes in Queensland. Detailed understanding of this pre-implementation period is critical for evaluating the impact of these changes moving forward.
Details
- Title
- Community Opioid Dispensing after Injury (CODI): Cohort characteristics and opioid dispensing patterns
- Authors
- C M Cameron (Corresponding Author) - Royal Brisbane and Women's HospitalRania Shibl (Author) - University of the Sunshine Coast, Queensland, School of Science, Technology and EngineeringS Cramb (Author) - Queensland University of TechnologyVictoria McCreanor (Author) - Queensland University of TechnologyMelanie Proper (Author) - Royal Brisbane and Women's HospitalJ Warren (Author) - Queensland University of TechnologyTanya Smyth (Author) - Royal Brisbane and Women's HospitalH E Carter (Author) - Queensland University of TechnologyKirsten Vallmuur (Author) - Queensland University of TechnologyNicholas Graves (Author) - Duke-NUS Medical SchoolNatalie K Bradford (Author) - Queensland University of TechnologyBill Loveday (Author) - Queensland Health
- Publication details
- Injury, Vol.55(3), pp.1-8
- Publisher
- Elsevier Ltd.
- DOI
- 10.1016/j.injury.2023.111216
- ISSN
- 1879-0267
- Data Availability
- The data that support the findings of this study are available from the Queensland Health Department. Restrictions apply to the availability of these data, which were used under licence for the current study, so are not publicly available.
- Grant note
- This study was supported by a Royal Brisbane and Women's Hospital Foundation Grant.
- Organisation Unit
- School of Science, Technology and Engineering
- Language
- English
- Record Identifier
- 99979096602621
- Output Type
- Journal article
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