Systematic assessment of non‐medical use of prescription drugs using doctor‐shopping indicators: A nation‐wide, repeated cross‐sectional study.
Aims: The aim of this study was to present the first nation‐wide, systematic, repeated assessment of doctor‐shopping (i.e. visiting multiple physicians to be prescribed the same drug) during 10 years for more than 200 psychoactive prescription drugs in the 67 million inhabitants in France. Design: T...
| Published in: | Addiction Vol. 118; no. 10; pp. 1984 - 1994 |
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| Main Authors: | , , , |
| Format: | equations & formulas research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Oct2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=171583264&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 171583264 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Oct2023 vid: 118 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 171583264 164237496 171583264 171583264 10.1111/add.16261 171583264 ppf: 1984 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Systematic assessment of non‐medical use of prescription drugs using doctor‐shopping indicators: A nation‐wide, repeated cross‐sectional study. aug: au: Soeiro, Thomas Pradel, Vincent Lapeyre‐Mestre, Maryse Micallef, Joëlle affil: Aix‐Marseille Université, Inserm, Marseille, France sug: subj: Psychotropic Drugs Drugs, Prescription Substance Abuse Evaluation Physicians Office Visits France Human Cross Sectional Studies Time Factors France Prescribing Patterns Drug Utilization Descriptive Statistics Resource Databases Mental Disorders Drug Therapy Funding Source ab: Aims: The aim of this study was to present the first nation‐wide, systematic, repeated assessment of doctor‐shopping (i.e. visiting multiple physicians to be prescribed the same drug) during 10 years for more than 200 psychoactive prescription drugs in the 67 million inhabitants in France. Design: This was a nation‐wide, repeated cross‐sectional study. Setting and Participants: Data are from the French National Health Data System in 2010, 2015 and 2019 for 214 psychoactive prescription drugs (i.e. anaesthetics, analgesics, antiepileptics, anti‐Parkinson drugs, psycholeptics, psychoanaleptics, other nervous system drugs and antihistamines for systemic use). Measurements The detection and quantification of doctor‐shopping relied upon an algorithm that detects overlapping prescriptions from repeated visits to different physicians. We used two doctor‐shopping indicators aggregated at population level for each drug dispensed to more than 5000 patients: (i) the quantity doctor‐shopped, expressed in defined daily doses (DDD), which measures the total quantity doctor‐shopped by the study population for a given drug; and (ii) the proportion doctor‐shopped, expressed as a percentage, which standardizes the quantity doctor‐shopped according to the use level of the drug. Findings The analyses included approximately 200 million dispensings to approximately 30 million patients each year. Opioids (e.g. buprenorphine, methadone, morphine, oxycodone and fentanyl), benzodiazepines and non‐benzodiazepine hypnotics (Z‐drugs) (e.g. diazepam, oxazepam, zolpidem and clonazepam) had the highest proportions doctor‐shopped during the study period. In most cases, the proportion and the quantity doctor‐shopped increased for opioids and decreased for benzodiazepines and Z‐drugs. Pregabalin had the sharpest increase in the proportion doctor‐shopped (from 0.28 to 1.40%), in parallel with a sharp increase in the quantity doctor‐shopped (+843%, from 0.7 to 6.6 DDD/100 000 inhabitants/day). Oxycodone had the sharpest increase in the quantity doctor‐shopped (+1000%, from 0.1 to 1.1 DDD/100 000 inhabitants/day), in parallel with a sharp increase in the proportion doctor‐shopped (from 0.71 to 1.41%). Detailed results for all drugs during the study period can be explored interactively at: https://soeiro.gitlab.io/megadose/. Conclusions: In France, doctor‐shopping occurs for many drugs from many pharmacological classes, and mainly involves opioid maintenance drugs, some opioids analgesics, some benzodiazepines and Z‐drugs and pregabalin. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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