JMIR Publications

ABSTRACT

Background:

There is an urgent need to reduce preventable deaths and hospitalisations from prescription opioid harms and minimise the negative effect opioid misuse can have on injured individuals, families, and the wider community. Data linkage between administrative hospitalisation records for injured patients and community opioid dispensing can improve our understanding of the health and surgical trajectories of injured persons and generate insights into corresponding opioid dispensing patterns.

Objective:

This study aims to link inpatient hospitalisation data with opioid dispensing data to examine the distribution and predictive factors associated with high or prolonged community opioid dispensing among adults, for two years following an injury-related hospital admission.

Methods:

This is a retrospective population-based cohort study of adults aged 18 years or older hospitalised with an injury in Queensland, Australia. The study involves the linkage of state-wide hospital admissions, opioid prescription dispensing and mortality data collections. All adults hospitalised for an injury between 01 January 2014 to 31 December 2015 will be included in the cohort. Demographics and injury factors are recorded at the time of the injury admission. Opioid dispensing data will be linked and extracted for 3 months prior to the injury admission date to two years after the injury separation date (last date 31 December 2017). Deaths data will be extracted for the two-year follow-up period. The primary outcome measure will be opioid dispensing (frequency and quantity) in the two years following the injury admission. Patterns and factors associated with community opioid dispensing will be examined for different injury types, mechanisms and population subgroups. Appropriate descriptive statistics will be used to describe the cohort. Regression models will be used to examine factors predictive of levels and duration of opioid use. Non-parametric methods will be applied when the data are not normally distributed.

Results:

The project is funded by the Royal Brisbane and Women’s Hospital Foundation. As of November 2021, all ethics and data custodian approvals have been granted. Data extraction and linkage has been completed. Data management and analysis is underway with results relating to an analysis for blunt chest trauma patients expected to be published in 2022.

Conclusions:

Little is currently known of the true prevalence or patterns of opioid dispensing following injury across Queensland. This study will provide new insights about factors associated with high and long-term opioid dispensing at a population level. This information is essential to inform targeted public policy and interventions to reduce the risk of prolonged opioid use and dependence for those injured. The novel work undertaken for this project will be vital to planning, delivering, monitoring and evaluating health care services for those injured. The findings of this study will be used to inform key stakeholders as well as clinicians and pain management services.