AUTHOR=Bedene Ajda , Strmljan Anita , van Dorp Eveline L. A. , Udovič Mitja , Lijfering Willem M. , Niesters Marieke , Rosendaal Frits R. , Dahan Albert , Fürst Jurij 

TITLE=Comparison of Two Different Analgesic Prescription Strategies and Healthcare Systems: Slovenia vs. the Netherlands

JOURNAL=Frontiers in Pain Research

VOLUME=2

YEAR=2021

URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2021.723797

DOI=10.3389/fpain.2021.723797

ISSN=2673-561X

ABSTRACT=<p><bold>Background:</bold> Prescribing practice of pain medication is changing in the Netherlands; opioids are used more often instead of nonsteroidal anti-inflammatory drugs (NSAIDs), therefore we aimed to compare the use of pain medication with Slovenia which has stringent prescribing rules for strong opioids.</p><p><bold>Methods:</bold> We conducted a cohort study into national prescription databases of the Netherlands and Slovenia covering pharmacy claims between January 1, 2013 and December 31, 2019. In the analysis about 17 million Dutch and 2 million Slovenian residents were included.</p><p><bold>Findings:</bold> The use of opioids and NSAIDs was higher in Slovenia than in the Netherlands. More frequent use of opioids in Slovenia could be almost entirely explained by weak opioids (about 6% of the population), whereas they were prescribed 50% less frequently in the Netherlands. The opioid use has increased by about 20% in the Netherlands (4.85 and 6.00% of the population in 2013 and 2018, respectively), and the majority of this increase could be explained by strong opioids (4.05% in 2018), specifically, by oxycodone whose use increased by more than 2-fold between 2013 and 2019. In comparison, oxycodone was seldomly used in Slovenia (about 0.3% of the population received a prescription in a year).</p><p><bold>Interpretation:</bold> When medication use is controlled by stringent prescribing rules, like for strong opioids in Slovenia, the use is lower as compared to when such rules do not exist.</p>