What do different databases tell about the use of opioids in seven European countries in 2002?

Katri Hamunen, Pirjo Laitinen-Parkkonen, Pirkko Paakkari, Harald Breivik, Torsten Gordh, Niels Henrik Jensen, Eija Kalso
European Journal of Pain: EJP 2008, 12 (6): 705-15

OBJECTIVE: The objective of this paper was to analyse opioid consumption in a number European countries using different sources of data.

METHODS: Data were extracted from the United Nations' International Narcotics Control Board Report (INCB) 2003 and from the registers of the national health authorities in seven countries where data were available for 2002. The amount of opioid used was calculated as daily defined doses per 1000 inhabitants per day (DDD/1000/day). Danish Register of Medicinal Products Statistics was further explored for characteristics of opioid consumption (age, gender, type of opioids consumed) by patients in primary care. Total opioid consumption and consumption of 11 selected opioids (7 strong and 4 weak) were analysed. The amount of opioids consumed by outpatients was also examined.

RESULTS: There were considerable differences in the number of opioids reported and significant discrepancies in the amounts of opioids consumed between the national data and the INCB report. The source of data for the national registers on drug consumption varied (pharmacies or wholesale). The INCB data provide information on opioid import and estimated need rather than on medical consumption.

CONCLUSIONS: Caution is required when interpreting the data on opioid consumption between countries because of differences in the collection and reporting of data. Better recording of opioid consumption is needed for meaningful analysis of opioid consumption and its possible effect on pain management in different countries. Data on opioids consumed for cancer-related pain in comparison with chronic non-malignant pain are needed. A uniform method of collection of data on analgesic consumption should be established for all European countries.

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