Do transdermal opioids reduce healthcare use in an Australian rural pain population? A comparison with oral opioids
Henshaw, JS, Do transdermal opioids reduce healthcare use in an Australian rural pain population? A comparison with oral opioids, Journal of Opioid Management, 7, (2) pp. 135 - 44. ISSN 1551-7489 (2011) [Refereed Article]
Objective: To determine ichether transdermal (TD) opioids reduce healthcare
contacts u·hen compared u·ith oral opioids in a rural population with chronic
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-
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