Evidence map›Paper›PMID 30852809›Full record

ArticleClinical drug investigation2019

Prescribing Trends of Codeine-containing Medications and Other Opioids in Primary Care After A Regulatory Decision: An Interrupted Time Series Analysis.

Niccolò Lombardi, Alfredo Vannacci, Alessandra Bettiol, Ettore Marconi, Serena Pecchioli, Alberto Magni, Claudio Cricelli, Francesco Lapi

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Article in Clinical drug investigation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
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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

8 authors.

Niccolò Lombardi *Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139, Florence, Italy.
Alfredo Vannacci *Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139, Florence, Italy.
Alessandra BettiolDepartment of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139, Florence, Italy.
Ettore MarconiHealth Search, Italian College of General Practitioners and Primary Care, Via Sestese,61, 50141, Florence, Italy.
Serena PecchioliHealth Search, Italian College of General Practitioners and Primary Care, Via Sestese,61, 50141, Florence, Italy.
Alberto MagniItalian College of General Practitioners and Primary Care, 50142, Florence, Italy.
Claudio CricelliItalian College of General Practitioners and Primary Care, 50142, Florence, Italy.
Francesco LapiHealth Search, Italian College of General Practitioners and Primary Care, Via Sestese,61, 50141, Florence, Italy. lapi.francesco@simg.it.ORCID http://orcid.org/0000-0002-4342-9128

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesIn 2014, the Italian Medicines Agency (AIFA) amended the summary of product characteristics of codeine-containing medications limiting their use for maximum three days. This study attempted to clarify the impact of AIFA intervention on prescribing trends and appropriateness of use of codeine-containing medications and other opioids.

methodsUsing the Health Search Database, a quasi-experimental interrupted time series analysis was conducted to evaluate changes in prescribing trends and appropriateness of use of codeine-containing medications and opioids between 2013 and 2015.

resultsPrescribing trends of codeine-containing medications significantly decreased (on average, - 352 days of treatment per month of observation), while long-acting opioids (LAOs) had an overall increase. Trends of inappropriate prescriptions significantly increased for two LAOs (i.e. tapentadol, naloxone-oxycodone), both before and after AIFA intervention.

conclusionThe use of paracetamol-codeine combination was effectively decreased in Italy because of AIFA intervention. Instead, prescriptions of tapentadol and oxycodone-naloxone stably increased over the study period irrespective of regulatory intervention. Given that the choice of the most appropriate opioid therapy is not straightforward, especially in elderly and/or comorbid patients, general practitioners should consider carefully alternative therapies on the bases of regulatory interventions.

Indexed as

Drug PrescriptionsAcetaminophenAgedAnalgesics, OpioidCodeineDrug CombinationsFemaleHumansInterrupted Time Series AnalysisItalyMaleMiddle AgedNaloxoneOxycodonePrimary Health CareAcetaminophenacetaminophen, codeine drug combinationAnalgesics, OpioidCodeineDrug CombinationsNaloxoneOxycodone

Identifiers

PMID30852809

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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.