Evidence map›Paper›PMID 25217680›Full record

ArticleCanadian family physician Medecin de famille canadien2014

Trends in high-dose opioid prescribing in Canada.

Tara Gomes, Muhammad M Mamdani, J Michael Paterson, Irfan A Dhalla, David N Juurlink

Registry-linked trialAbstract read
PubMed Full text at PMC
In one paragraph

Article in Canadian family physician Medecin de famille canadien, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03106129 (Opioid Requirements Post Discharge of Patients Having Total Knee Arthroplasty), which is not on this map. Cited by 80 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03106129 unknown statusnot on this mapstarted 2017, after this paper: background citation

Opioid Requirements Post Discharge of Patients Having Total Knee Arthroplasty (TKA)

TypeobservationalSponsorSunnybrook Health Sciences CentreRan2017 to 2022Enrolled200ConditionsKnee Arthropathy, Opioid Use, Pain, Rehabilitation
3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Tara GomesScientist at the Institute for Clinical Evaluative Sciences; Assistant Professor at the Institute for Health Policy, Management and Evaluation and the Leslie Dan Faculty of Pharmacy at the University of Toronto; and Scientist at the Li Ka Shing Knowledge Institute at St Michael's Hospital in Toronto, Ont. gomest@smh.ca.
Muhammad M MamdaniScientist at the Institute for Clinical Evaluative Sciences; Professor at the Institute for Health Policy, Management and Evaluation, the Department of Medicine, and the Leslie Dan Faculty of Pharmacy at the University of Toronto; and Scientist at the Li Ka Shing Knowledge Institute and the Department of Medicine at St Michael's Hospital.
J Michael PatersonScientist at the Institute for Clinical Evaluative Sciences and Assistant Professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto and the Department of Family Medicine at McMaster University in Hamilton, Ont.
Irfan A DhallaScientist at the Institute for Clinical Evaluative Sciences; Assistant Professor at the Institute for Health Policy, Management and Evaluation and the Department of Medicine at the University of Toronto; and Associate Scientist at the Li Ka Shing Knowledge Institute and the Department of Medicine at St Michael's Hospital.
David N JuurlinkScientist at the Institute for Clinical Evaluative Sciences; Scientist at the Sunnybrook Research Institute; and Professor at the Institute for Health Policy, Management and Evaluation, the Department of Medicine, and the Department of Pediatrics at the University of Toronto.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo describe trends in rates of prescribing of high-dose opioid formulations and variations in opioid product selection across Canada.

designPopulation-based, cross-sectional study.

settingCanada.

participantsRetail pharmacies dispensing opioids between January 1, 2006, and December 31, 2011.

main outcome measuresOpioid dispensing rates, reported as the number of units dispensed per 1000 population, stratified by province and opioid type.

resultsThe rate of dispensing high-dose opioid formulations increased 23.0%, from 781 units per 1000 population in 2006 to 961 units per 1000 population in 2011. Although these rates remained relatively stable in Alberta (6.3% increase) and British Columbia (8.4% increase), rates in Newfoundland and Labrador (84.7% increase) and Saskatchewan (54.0% increase) rose substantially. Ontario exhibited the highest annual rate of high-dose oxycodone and fentanyl dispensing (756 tablets and 112 patches per 1000 population, respectively), while Alberta's rate of high-dose morphine dispensing was the highest in Canada (347 units per 1000 population). Two of the highest rates of high-dose hydromorphone dispensing were found in Saskatchewan and Nova Scotia (258 and 369 units per 1000 population, respectively). Conversely, Quebec had the lowest rate of high-dose oxycodone and morphine dispensing (98 and 53 units per 1000 population, respectively).

conclusionWe found marked interprovincial variation in the dispensing of high-dose opioid formulations in Canada, emphasizing the need to understand the reasons for these differences, and to consider developing a national strategy to address opioid prescribing.

Indexed as

Analgesics, OpioidPain ManagementCanadaDose-Response Relationship, DrugHumansMedication Therapy ManagementNeeds AssessmentPractice Patterns, Physicians'Analgesics, Opioid

Identifiers

PMID25217680
PMCPMC4162700

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.