National consumption of opioid and nonopioid analgesics in Croatia: 2007&amp;ndash;2013

Krnić, Darko; Anić-Matić, Andrea; Došenović, Svjetlana; Draganić, Pero; Zezelic, S; Puljak, Livia

doi:10.2147/tcrm.s86226

Cited by 6 publications

(10 citation statements)

References 19 publications

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“…Increasing consumption of analgesics in Croatia has been recently reported, 26 but our study also points out that there are still deficiencies in pain treatment following surgery. Even though there is evidence that prescribing patterns are changing, 27 there is still plenty to be done in the field of postoperative pain management.…”

Section: Discussionsupporting

confidence: 59%

Risk factors associated with postoperative pain after ophthalmic surgery: a prospective study

Lešin¹,

Lozo²,

Duplancic-Sundov³

et al. 2016

TCRM

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BackgroundRisk factors associated with postoperative pain intensity and duration, as well as consumption of analgesics after ophthalmic surgery are poorly understood.MethodsA prospective study was conducted among adults (N=226) who underwent eye surgery at the University Hospital Split, Croatia. A day before the surgery, the patients filled out questionnaires assessing personality, anxiety, pain catastrophizing, sociodemographics and were given details about the procedure, anesthesia, and analgesia for each postoperative day. All scales were previously used for the Croatian population. The intensity of pain was measured using a numerical rating scale from 0 to 10, where 0 was no pain and 10 was the worst imaginable pain. The intensity of pain was measured before the surgery and then 1 hour, 3 hours, 6 hours, and 24 hours after surgery, and then once a day until discharge from the hospital. Univariate and multivariate analyses were performed.ResultsA multivariate analysis indicated that independent predictors of average pain intensity after the surgery were: absence of premedication before surgery, surgery in general anesthesia, higher pain intensity before surgery and pain catastrophizing level. Independent predictors of postoperative pain duration were intensity of pain before surgery, type of anesthesia, and self-assessment of health. Independent predictors of pain intensity ≥5 during the first 6 hours after the procedure were the type of procedure, self-assessment of health, premedication, and the level of pain catastrophizing.ConclusionAwareness about independent predictors associated with average postoperative pain intensity, postoperative pain duration, and occurrence of intensive pain after surgery may help health workers to improve postoperative pain management in ophthalmic surgery.

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Section: Discussionsupporting

confidence: 59%

Risk factors associated with postoperative pain after ophthalmic surgery: a prospective study

Lešin¹,

Lozo²,

Duplancic-Sundov³

et al. 2016

TCRM

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“…Among a plethora of treatments, opioid agonists are one pharmacotherapy for moderate-severe pain. Although its consumption by country (mg/capita) has increased in the last two decades [ 2 , 3 , 4 ], it may remain under-requirements for managing moderate-severe pain in some regions, including Asian countries [ 1 , 4 , 5 ]. According to the 2015 opioid consumption data, the medical opioid consumption in the United States (U.S.) was 678 mg/capita while in South Korea (S. Korea), it was 55 mg/capita which was below average, ranking 43rd globally and 30th among thirty-five Organisation for Economic Cooperation and Development (OECD) countries (258 mg/capita average in OECD countries) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

Castañeda

Lee

Kim

et al. 2018

JCM

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Opioid consumption has increased worldwide, which carries the risk of opioid use disorder (OUD). However, the literature on OUD and opioid-related chemical coping (OrCC) in chronic noncancer pain (CNCP) is heterogeneous, with most studies conducted in the United States. We performed a multicenter, observational, cross-sectional study to address OrCC in long-term opioid therapy (LtOT) for CNCP in South Korea. The objectives were to determine the frequency and predictors of OrCC. We included 258 patients. Among them, fifty-five (21%) patients showed OrCC. The sample had high pain catastrophizing (≥30 points; 66%), moderate-severe insomnia (≥15 points; 63%), low resilience (68 points), and high suicidal ideation (67%). OrCC patients had greater pain interference (85.18% vs. 58.28%, p = 0.017) and lower satisfaction with the LtOT (56.4% vs. 78.3%, p = 0.002). In multivariable analysis, alcohol abuse (OR = 6.84, p = 0.001), prescription drugs abuse (OR = 19.32, p = 0.016), functional pain (OR = 12.96, p < 0.001), head and neck pain (OR = 2.48, p = 0.039), MEDD (morphine equivalent daily dose) ≥ 200 mg/day (OR = 3.48, p = 0.006), and ongoing litigation (OR = 2.33, p = 0.047) were significant predictors of OrCC. In conclusion, the break-out of OrCC in CNCP in South Korea was comparable to those in countries with high opioid consumption, such as the United States, regardless of the country’s opioid consumption rate.

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“…Opioid consumption level in Spain, Italy, Greece, and Croatia was significantly lower than in Germany, Austria, Belgium, and Denmark ( 22 – 24 ). Our previous investigation showed that the total opioid analgesic consumption in Serbia, in 2012 and 2013, was 8.83 and 8.55 times lower than in Croatia, respectively ( 25 ).…”

Section: Discussionmentioning

confidence: 88%

“…However, European countries themselves had different trends in the opioid utilization. Study performed from 2002 to 2006 showed increased consumption of opioids in all Scandinavian countries, except Sweden, concerning oxycodone, fentanyl, and methadone ( 21 , 22 ). Morphine had decreasing consumption trend ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…As it was already mentioned, total opioid analgesic consumption in Serbia, in 2012 and 2013, was even 8.83 and 8.55 times lower than in Croatia, respectively ( 25 ). In general, consumption of morphine in Croatia was higher in comparison to Serbia, according to data in 2007 onward ( 22 , 34 – 36 ). Moreover, study performed in nine western European countries (Belgium, Germany, Italy, Norway, Spain, Ireland, United Kingdom, Portugal, and Netherlands) has shown that the consumption of morphine was the lowest in all countries in comparison to other opioid analgesics (fentanyl, tramadol, and codeine); morphine consumption was about three times lower comparing with the consumption of transdermal fentanyl ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Utilization of Parenteral Morphine by Application of ATC/DDD Methodology: Retrospective Study in the Referral Teaching Hospital

Dragojević-Simić

Rančić

Stamenković

et al. 2017

Front. Public Health

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BackgroundFew studies analyzed the pattern of opioid analgesic utilization in hospital settings. The aim of this study was to determine the consumption pattern of parenteral morphine in patients hospitalized in the Serbian referral teaching hospital and to correlate it with utilization at the national and international level.MethodsIn retrospective study, the required data were extracted from medical records of surgical patients who received parenteral morphine in the 5-year period, from 2011 to 2015. We used the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (DDD) international system for consumption evaluation.ResultsWhile the number of performed surgical procedures in our hospital steadily increased from 2011 to 2015, the number of inpatient bed-days decreased from 2012. However, the consumption of parenteral morphine varied and was not more than 0.867 DDD/100 bed-days in the observed period.ConclusionBased on the available data, parenteral morphine consumption in our hospital was lower compared with international data. The low level of morphine use in the hospital was in accordance with national data, and compared with other countries, morphine consumption applied for medical indications in Serbia was low. Adequate legal provision to ensure the availability of opioids, better education and training of medical personnel, as well as multidisciplinary approach should enable more rational and individual pain management in the future, not only within the hospitals.

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National consumption of opioid and nonopioid analgesics in Croatia: 2007–2013

Cited by 6 publications

References 19 publications

Risk factors associated with postoperative pain after ophthalmic surgery: a prospective study

Risk factors associated with postoperative pain after ophthalmic surgery: a prospective study

Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

Utilization of Parenteral Morphine by Application of ATC/DDD Methodology: Retrospective Study in the Referral Teaching Hospital

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