Do transdermal opioids affect the personal socio-economic costs of healthcare access in an Australian rural pain population? A comparison with oral opioids

Do transdermal opioids affect the personal socio-economic costs of healthcare access in an Australian rural pain population? A comparison with oral opioids. Objective: To determine whether there are differences in the personal socio-economic costs of healthcare access between transdermal and oral opioid use in a rural population with chronic non cancer pain (CNCP). Design: An observational longitudinal study, measuring change in the self reported personal time and expense of healthcare access by route of opioid administration over time (monthly for one year). Subjects were opioid treated CNCP patients from North West Tasmania, Australia. Subjects completed monthly datasheets by recording all personal healthcare access time and expense, together with the route(s) of opioid administration. The outcome measures of mean monthly healthcare time (MHT) and expense (MHE), by route of opioid administration were analysed using generalised estimating equations with robust standard errors. Results: The details of 10564 healthcare contacts from 198 subjects were obtained during the study. Total mean MHT with OCR opioids was 3.68hrs (95%CI = 2.11- 5.44) and unchanged (p=0.63) with TD opioids at 3.41hrs (95%CI= 2.16-4.66). Total mean MHE with oral opioids was AU$92.72 (95%CI = 51.21 to 134.24) and unchanged (p=0.81) with TD opioids at AU$89.12 (95%CI = 54.53-123.71). Conclusions: The personal socioeconomic costs of healthcare access for CNCP rural patients are similar for TD and oral opioid use. The prolonged analgesic affect of TD opioids may be advantageous for rural populations.