Trends in analgesic consumption in France over the last 10 years and comparison of patterns across Europe

Hider‐Mlynarz, Karima; Cavalié, Philippe; Maison, Patrick

doi:10.1111/bcp.13564

Cited by 135 publications

(124 citation statements)

References 46 publications

(62 reference statements)

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“…A questionnaire‐based study addressing the risk of misuse and dependence on nonprescription analgesics in French community pharmacies indicates a rate of misuse of codeine close to 7%, while no misuse emerged from the answers of the 107 individuals taking paracetamol (Roussin, Bouyssi, Pouché, Pourcel, & Lapeyre‐Mestre, ). This is in accordance with a more recent study showing that paracetamol, whose consumption is particularly high in France in comparison with other Western European countries (Hider‐Mlynarz, Cavalié, & Maison, ), was correctly used in terms of indication, dosing and frequency by 86% of individuals (Severin et al, ). A cross‐sectional survey based on telephone interviews of nearly 2,000 Australian OTC drug consumers showed that 96% were using paracetamol appropriately, while they were 69% regarding NSAIDs (Stosic, Dunagan, Palmer, Fowler, & Adams, ).…”

Section: Resultssupporting

confidence: 89%

“…In this respect, a systematic review of the literature coupled with a meta-analysis included five randomized clinical trials corresponding to an overall assessment of one thousand patients with chronic pain resulting from multiple aetiologies, headache/migraine or knee osteoarthritis and followed for at least 3 months (Hadi, Alldred, Briggs, Munyombwe, & Closs, 2014). Interventions consisted in face-to-face or telephonebased medication review and, in one study, recommendations to GPs (Gammaitoni et al, 2000;Hay et al, 2006;Marra et al, 2012). The analysis demonstrated that pharmacist-led medication was associated with a significant decrease in pain intensity and an improvement of both physical functioning and patient satisfaction.…”

Section: Pharmacists Interventions In Analgesic Otc: Rationale Objmentioning

confidence: 99%

See 1 more Smart Citation

Self‐medication in pain management: The state of the art of pharmacists’ role for optimal Over‐The‐Counter analgesic use

Perrot

Cittée²,

Louis

et al. 2019

European Journal of Pain

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Background and Objective Self‐medication is associated with an important utilization of Over‐The‐Counter (OTC) analgesics. The medical outcome resulting from therapeutic options bypassing the physician prescription is a major issue. In that context, pharmacists are expected to play a crucial role. The main objective of this review was to analyse the state‐of‐the art of pharmacists' role in pain management self‐medication. Databases and Data Treatment An expert multidisciplinary group dedicated to self‐medication in pain was established. Selection of publications was performed from PubMedand EMBASE databases which was based on the use of “pain” and/or “self‐medication” and/or “self‐care” and/or “analgesics” and/or “painkillers” keywords, restricted to the past 10 years. Results A total of 480 papers were identified, 49 of which papers were considered relevant and finally kept for final discussion, on OTC pain management and pharmacist's role. Literature analysis demonstrates that OTC analgesics are generally safe when appropriately used. Risks associated with misuse or inappropriateness depend on patients’ vulnerability (elderly, pregnancy) or behaviour. Social cognitive theory‐based intervention and multimedia applications improve self‐medication but do not replace health care professional advice Pharmacists’ interventions may improve the benefits and safety of OTC analgesic medication, with a better management of pain. Conclusions Considering the heterogeneity of patients’ knowledge and behaviour reported worldwide, inappropriate use of OTC pain medication should not be underestimated. Community pharmacists are ideally placed to guide self‐medication or recommend a medical advice when needed. Embedding pharmacists in primary care pain management is essential and pharmacist‐led medication coupled with an appropriate training of pharmacy staffs should be encouraged. Significance Analgesics are widely used without prescription, all over the world. They represent the largest market of OTC drugs, with an overall benefit/risk ratio favourable when appropriately used. Because of potential individual risks associated to the ailment or to the patient's behaviour, pharmacists’ interventions have proven to optimize analgesic self‐medication, provided that pharmacy staffs are both available and more specifically trained. In the future, in pain management, especially self‐medication, pharmacists should play an increasing role and should be included in educational programmes and pain management guidelines.

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Section: Resultssupporting

confidence: 89%

Section: Pharmacists Interventions In Analgesic Otc: Rationale Objmentioning

confidence: 99%

Self‐medication in pain management: The state of the art of pharmacists’ role for optimal Over‐The‐Counter analgesic use

Perrot

Cittée²,

Louis

et al. 2019

European Journal of Pain

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“…We can even notice that if older people (≥85 years) remained the most exposed to atropinics between 2006 and 2015, these patients had the most pronounced atropinic burden decrease. Secondly, dextropropoxyphene was the most used drug before 2010 . These high percentages of use explain the major impact observed after the changes in its regulatory status, even if these regulatory measures were not directly related to their atropinic properties.…”

Section: Discussionmentioning

confidence: 99%

“…In 2011 and 2014, new guidelines restricted the use of domperidone due to the risk of cardiac events, with a particular focus on elderly: Thus, domperidone was not recommended for people aged 60 years and over . Thirdly, dextropropoxyphene withdrawal led to a switch toward paracetamol, tramadol, codeine, and opium powder in elderly people with chronic pain as well as in the general population .…”

Section: Discussionmentioning

confidence: 99%

Trends of atropinic (anticholinergic) exposure in the elderly: a 10‐year analysis in the French EGB database

Germay

Rueter

Montastruc

et al. 2019

Fundamemntal Clinical Pharma

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Atropinic drugs are known to potentially induce physical and/or mental impairments in the elderly. The aim of this study was to investigate trends of atropinic exposure in patients ≥65 years in France between 2006 and 2015. A repeated cross‐sectional study was performed quarterly from January 1, 2006 to December 31, 2015, in the ‘Echantillon Généraliste des Bénéficiaires (EGB)’, a representative sample of the French population. Exposed patients were identified using the Anticholinergic Durán's list. Outcomes were rate of patients exposed to at least one atropinic drug (atropinic prevalence rate) and atropinic burden per patient (sum of atropinic burden scores). Interrupted time series were used to analyze the impact of market withdrawal of some drugs with atropinic properties during the period of the study. The number of patients ≥65 years registered in the EGB ranged from 75 611 in 2006 to 95 389 in 2015. Atropinic prevalence rate decreased significantly from 45.6% in 2006 to 33.2% in 2015 (−12.4%, slope significance P < 0.05). Subjects aged ≥85 years were the most exposed. Total atropinic burden decreased significantly between 2006 and 2015 (2.2 ± 1.7 in 2006; 2.0 ± 1.5 in 2015; slope significance P < 0.05), especially in patients ≥85 years. Market withdrawals for safety reasons of some atropinic drugs were significantly associated with a decrease in the atropinic prevalence rate (P < 0.05) and atropinic burden per patient (P < 0.05). In conclusion, atropinic drug exposure in the elderly significantly decreased in France between 2006 and 2015. This decrease can be partly explained by regulatory measures against some atropinic drugs.

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“…Other countries typically did not use strong opioids for pain relief or tended to place greater restrictions on their use. For example, France has relatively high consumption of painkillers, but it consumes primarily non‐opioids and has very low use of strong opioids (Hider‐Mlynarz, Cavalie, and Maison ). Prior to 2008, Norway did not reimburse opioids for non‐cancer pain (Hamunen et al.…”

Section: Factors Contributing To High Us Drug Overdose Mortalitymentioning

confidence: 99%

The Contemporary American Drug Overdose Epidemic in International Perspective

Ho¹

2019

Population & Development Rev

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Trends in analgesic consumption in France over the last 10 years and comparison of patterns across Europe

Abstract: Paracetamol consumption is clearly highest in France, whereas its use of strong opioids is among the lowest in Europe, although its consumption of oxycodone has increased significantly. Further studies are required specifically to monitor these drugs.

Cited by 135 publications

References 46 publications

Self‐medication in pain management: The state of the art of pharmacists’ role for optimal Over‐The‐Counter analgesic use

Self‐medication in pain management: The state of the art of pharmacists’ role for optimal Over‐The‐Counter analgesic use

Trends of atropinic (anticholinergic) exposure in the elderly: a 10‐year analysis in the French EGB database

The Contemporary American Drug Overdose Epidemic in International Perspective

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