Evidence map›Paper›PMID 33173012›Full record

ArticleBMJ global health2020

Relation between opioid consumption and inclusion of opioids in 137 national essential medicines lists.

Georgia C Richards, Jeffrey K Aronson, Carl Heneghan, Kamal R Mahtani, Constantinos Koshiaris, Nav Persaud

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
5.8field-weighted citation impact, top 3% of its field
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

8 citing papers in PubMed, 23 citations in OpenAlex.

  1. Article
  2. Review
  3. Averting a UK opioid crisis: getting the public health messages 'right'.Journal of the Royal Society of Medicine · 2022
    Article
  4. Observational
  5. Article
  6. Article
  7. Review
  8. Article
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

6 authors at 2 institutions in 2 countries.

Georgia C RichardsCentre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK georgia.richards@kellogg.ox.ac.uk.
Jeffrey K AronsonCentre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Carl HeneghanCentre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Kamal R MahtaniCentre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Constantinos KoshiarisNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Nav PersaudDepartment of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
University of Oxford · GBUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOpioids are deemed essential medicines by the World Health Organization (WHO). However, many countries have inadequate access to them. Whether including opioids in national essential medicines lists (EMLs) influences national opioid consumption has not been evaluated.

methodsWe conducted a cross-sectional study to determine whether the listing of opioids in national EMLs was associated with consumption. We quantified the numbers and types of all opioids included in 137 national EMLs, for comparison with opioids in the WHO's Model List of Essential Medicines. Using the International Narcotics Control Board (INCB) consumption statistics for 2015-2017, we assessed the relation between annual mean opioid consumption (mg/person) and the numbers of opioids included in EMLs, controlling for region, population, healthcare expenditure, life expectancy, gross domestic product, human development and corruption.

resultsFive opioids were included in the 20th edition of the WHO's Model List of Essential Medicines: codeine, fentanyl, loperamide, methadone and morphine. On average, countries' lists included significantly (p<0.05) more opioids than the WHO's Model List. However, there were wide variations in the numbers (median 6 opioids; IQR: 5-9) and types (n=33) of opioids included in national EMLs. Morphine (95%), fentanyl (83%) and codeine (69%) were the most commonly included opioids. Most national EMLs were out of date (median publication date: 2011, IQR: 2009-2013). After adjusting for country characteristics, there was no relation between mean opioid consumption and the number of opioids in EMLs.

conclusionsIncluding opioids in national EMLs was not associated with consumption. National EMLs should be regularly updated to reflect the availability of opioids and the populations' needs for managing pain.

Indexed as

Analgesics, OpioidDrugs, EssentialCross-Sectional StudiesHealth ExpendituresHumansWorld Health OrganizationAnalgesics, OpioidDrugs, Essentialepidemiologyhealth policypharmacologypublic healthtreatment

Identifiers

PMID33173012
PMCPMC7656944
OpenAlexW3100978971

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.