Do transdermal opioids reduce healthcare use in an Australian rural pain population? A comparison with oral opioids

Objective: To determine ichether transdermal (TD) opioids reduce healthcare contacts u·hen compared u·ith oral opioids in a rural population with chronic no11ca11cerpain (C.YCP). Design: An obserl'ational longitudinal study to measure the changes in selfrepm1ed healthcare use by the route of opioid administration over time (monthly for 1 year). Subjects u·ere opioid-treated CSCP patients from North West Tasmania. Tbe subjects completed the month~v datasheets by recording all healthcare contacts and the routes of opioid administration. Tbe outcome measures of mean monthly healthcare contacts (JJHCs) by the routes of opioid administration were analyzed using generalized estimating equations u·ith robust standard errors. Results: The details of 10,564 healthcare contacts from 198 subjects were obtai11ed during the study. General practitioner (GP) mean }vfHCs were 2.01 (95% confidence interrnls [CI} = 1.58-2.45) for oral opioids and significantly (p = 0.02) /airer by 0.38 (95% CI= -0. 70 to -0.05) contacts for TD opioids. Pharmacy mea11 JIHCs u·ere 2.44 (95% CI= 1.88-3.00) for oral opioids and unchanged (p = 0.86) by -0.04 (95% CI= -0.44-0.37)for TD opioids. Total 111ea11 J1HCs u·ith oral opioid use icere 5.98 (95% CI= 4.93- 7.03). With TD opioid use, this u·as nonsign(ficantzr lou•er (p = 0.12) by 0.62 (95% CI= -1.40- 0.15) contacts. Conclusions: Tbe use of TD opioid preparations, u•ith their prolonged analgesic effect. may reduce total healthcare activi(V and significantly reduce GP contact. Tbis maypm1icular~v benefit a rural population where there is a relative shortage of doctors.