Journal article
Community Opioid Dispensing after Injury (CODI): Cohort characteristics and opioid dispensing patterns
Injury, Vol.55(3), pp.1-8
01/03/2024
PMID: 38000939
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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 ‘Community Opioid Dispensing after Injury’ 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
- Creators
- C. M. Cameron - Queensland University of TechnologyR. Shibl - University of the Sunshine CoastS. Cramb - Queensland University of TechnologyV. McCreanor - Queensland University of TechnologyM. Proper - Royal Brisbane and Women's HospitalJ. Warren - Queensland University of TechnologyT. Smyth - Royal Brisbane and Women's HospitalH. E. Carter - Queensland University of TechnologyK. Vallmuur - Queensland University of TechnologyN. Graves - Duke-NUS Medical SchoolN. Bradford - Queensland University of TechnologyB. Loveday - Queensland Health
- Publication Details
- Injury, Vol.55(3), pp.1-8
- Publisher
- Elsevier Ltd
- Grant note
- This study was supported by a Royal Brisbane and Women’s Hospital Foundation Grant.
- Identifiers
- 991013351040002368
- Copyright
- © 2023 Elsevier Ltd. All rights reserved.
- Academic Unit
- Faculty of Science and Engineering
- Language
- English
- Resource Type
- Journal article