Artikel
Growing regional differences by urbanity and socioeconomic deprivation in the prescription prevalence of opioid analgesics for non-cancer pain: results based on German claims data from 2004 to 2020
Wachsende regionale Unterschiede nach Urbanität und sozioökonomischer Benachteiligung in der Verschreibungsprävalenz von Opioid-Analgetika bei nicht-tumorbedingten Schmerzen: Ergebnisse basierend auf deutschen Krankenkassendaten von 2004 bis 2020
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Autoren
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Oliver Scholle
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
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Kathrin Jobski
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Jost Viebrock
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
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Ulrike Haug
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| Veröffentlicht: | 13. November 2024 |
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Gliederung
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Background: Regional differences in opioid prescribing might reflect differences in population characteristics or varying prescribing practices. This study aimed to analyze how time trends in the prescription prevalence of opioid analgesics for non-cancer pain in Germany vary across key regional characteristics.
Materials and Methods: We conducted annual cross-sectional studies for the years 2004 to 2020 based on the German Pharmacoepidemiological Research Database (GePaRD; claims data from 20% of the German population). We included all persons with continuous insurance or those who were born or died in the respective year, and identified all outpatient prescriptions of opioid analgesics prescribed to persons without cancer/palliative care in the same year. Using the person’s region of residence at the district level, we then calculated the age- and sex-standardized prescription prevalence (number of persons with ≥1 prescription per 1,000/year) overall and by regional characteristics (urban-rural classification and socioeconomic deprivation using the German Index of Socioeconomic Deprivation). The study was financed by the German Federal Institute for Drugs and Medical Devices (BfArM).
Results: The number of eligible persons ranged between 11,372,001 (2004) and 17,111,339 (2020). From 2004 to 2020, the overall standardized prescription prevalence decreased steadily from 50.9 to 36.0 per 1,000/year (by 29%). In large urban cities, it decreased from 51.0 to 34.9 per 1,000/year (by 32%), and in sparsely populated rural districts, it decreased from 51.6 to 44.2 per 1,000/year (by 14%). Considering regional socioeconomic deprivation, the prescription prevalence decreased from 49.1 to 31.9 per 1,000/year (by 35%) in the least deprived quintile and from 52.9 to 44.0 per 1,000/year (by 17%) in the most deprived quintile. The patterns show that regional differences emerged continuously over the study period.
Conclusion: We observed a decrease in the prescription prevalence of opioid analgesics for non-cancer pain between 2004 and 2020 in Germany, independently of urbanity and regional socioeconomic deprivation. However, the extent of the decrease varied according to these characteristics, resulting in growing differences in opioid prescribing practices across regions by the end of the study period.
