Observational studyDrug safety2022
Sales of Over-the-Counter Products Containing Codeine in 31 Countries, 2013-2019: A Retrospective Observational Study.
Observational study in Drug safety, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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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.
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.
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Who cites it
10 citing papers in PubMed, 22 citations in OpenAlex.
- Article
- Trends in analgesia prescribing in primary care in Ireland and England between 2014 and 2022: A repeated cross-sectional study.British journal of clinical pharmacology · 2025Article
- Patterns of Analgesic Prescribing and High-Risk Prescribing in Primary Care in Ireland 2014-2022-A Repeated Cross-Sectional Study.European journal of pain (London, England) · 2025Article
- Nudging strategies to influence prescribers' behavior toward reducing opioid prescriptions: a systematic scoping review.The Journal of international medical research · 2024Article
- Preventable suicides involving medicines: A systematic case series of coroners' reports in England and Wales.Public health in practice (Oxford, England) · 2024Article
- The misuse of codeine containing medicines: Perceptions and behaviours of qualified pharmacy professionals.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- Private prescribing of controlled opioids in England, 2014-2021: a retrospective observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Observational
- Preventable deaths involving opioids in England and Wales, 2013-2022: a systematic case series of coroners' reports.Journal of public health (Oxford, England) · 2023Article
- Over-the-Counter Drug Misuse and Dependence: Public Health Ethics' Foray into Fight against the Codeine Crisis.Pharmacy (Basel, Switzerland) · 2022Article
- Sales of Over-the-Counter Products Containing Codeine in 31 Countries, 2013-2019: A Retrospective Observational Study.Drug safety · 2022Observational
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
introductionOpioid prescribing trends have been investigated in many countries. However, the patterns of over-the-counter purchases of opioids without a prescription, such as codeine combinations, are mostly unknown.
objectiveWe aimed to assess national sales and expenditure trends of over-the-counter codeine-containing products purchased in countries with available data over 6 years.
methodsWe conducted a retrospective observational study using electronic point-of-sale data from the human data science company, IQVIA, for countries that had such data, including Argentina, Belgium, Brazil, Bulgaria, Canada, Croatia, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Japan, Latvia, Lithuania, Mexico, the Netherlands, Poland, Portugal, Romania, Russia, Serbia, Slovakia, Slovenia, South Africa, Spain, Switzerland, Thailand, the UK, and the USA. We calculated annual mean sales (dosage units/1000 population) and public expenditure (£/1000 population) for each country between April 2013 and March 2019 and adjusted for data coverage reported by IQVIA. We quantified changes over time and the types of products sold.
resultsIn total, 31.5 billion dosage units (adjusted: 42.8 billion dosage units) of codeine, costing £2.55 billion (adjusted: £3.68 billion), were sold over the counter in 31 countries between April 2013 and March 2019. Total adjusted sales increased by 11% (from 3911 dosage units/1000 population in 2013 to 4358 in 2019) and adjusted public expenditure increased by 72% (from £263/1000 in 2013 to £451/1000 in 2019). Sales were not equally distributed; South Africa sold the most (36 mean dosage units/person), followed by Ireland (30 mean dosage units/person), France (20 mean dosage units/person), the UK (17.2 mean dosage units/person), and Latvia (16.8 mean dosage units/person). Types of products (n = 569) and formulations (n = 12) sold varied.
conclusionIn many parts of the world, substantial numbers of people may be purchasing and consuming codeine in over-the-counter products. Clinicians should ask patients about their use of over-the-counter products, and public health measures are required to improve the collection of sales data and the safety of such products. STUDY PROTOCOL PRE-REGISTRATION: https://osf.io/ay4mc . The pre-print version of this work is available on medRxiv: https://doi.org/10.1101/2021.04.21.21255888 .
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