Prescribing patterns of tramadol in adults in IMS® primary care databases in France and Germany between 1 January 2006 and 30 June 2016

Karin Hedenmalm, Jim Slattery, Izabela Skibicka-stepien, Xavier Kurz, Daniel Morales

Research output: Contribution to journalArticle

3 Citations (Scopus)
115 Downloads (Pure)

Abstract

Purpose
There is increasing concern with regard to fatal intoxications with prescription opioids and tramadol poisonings. This study aimed to characterise prescribing patterns for tramadol in primary care in France and Germany and identify long-term treatment and potential risk factors for such treatment.

Methods
Adult patients-prescribed tramadol between January 2006 and June 2016 in GP practices in IMS® Disease Analyzer databases in France and Germany were identified. Six-monthly prevalence and mean doses and durations were calculated by gender, age group and type of tramadol product. The proportion of incident use that resulted in treatment ≥ 366 days was calculated. The odds for long-term treatment was analysed in relation to gender, age group, type of tramadol product, start dose, indication and a diagnosis of abuse or misuse.

Results
Overall prescribing of tramadol decreased in Germany and increased, then plateaued in France. Prescribing was higher in females. Predominantly prescribed products were tramadol in combination with paracetamol (COMB) in France and slow release formulations of tramadol (SR-TRAM) in Germany. SR-TRAM had the highest mean doses and durations, followed by immediate release formulations of tramadol (IR-TRAM) and COMB. Around 1.5% of incident tramadol use in France and 8.2% in Germany resulted in long-term treatment. Long-term treatment was associated with increasing age, SR-TRAM and a diagnosis of abuse or misuse.

Conclusions
The risk of long-term treatment appeared to increase with increasing age. Potential risk factors for long-term treatment included initiating treatment with SR-TRAM and a diagnosis of abuse or misuse.
Original languageEnglish
Pages (from-to)707-716
Number of pages10
JournalEuropean Journal of Clinical Pharmacology
Volume75
Issue number5
Early online date23 Jan 2019
DOIs
Publication statusPublished - May 2019

Keywords

  • Chronic pain
  • Clinical pharmacology
  • Drug utilisation
  • Opioids
  • Pain

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