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Lam T, Biggs N, Xia T, Evans J, Stevens J, da Gama M, Lubman DI, Nielsen S. Comparing opioid types in the persistence of opioid use following surgical admission: a study protocol for a retrospective observational linkage study comparing tapentadol and oxycodone in Australia. BMJ Open 2022; 12:e060151. [PMID: 35418442 PMCID: PMC9014068 DOI: 10.1136/bmjopen-2021-060151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Each year, an estimated two million Australians commence opioids, with 50 000 developing longer-term (persistent) opioid use. An estimated 3%-10% of opioid-naïve patients prescribed opioids following surgery develop persistent opioid use. This study will compare rates of persistent opioid use between two commonly used postoperative opioids, oxycodone and tapentadol, to understand if initial postoperative opioid type is important in determining longer-term outcomes. METHODS AND ANALYSIS A retrospective data linkage study that analyses administrative data from hospital and community pharmacies. Data will be obtained from at least four pharmacies that service large hospitals with comparable supplies of oxycodone and tapentadol. The study will include at least 6000 patients who have been dispensed a supply of oxycodone or tapentadol to take home following their discharge from a surgical ward. The primary outcome measure will be persistent opioid use at 3 months postdischarge for opioid naïve people who receive either immediate release tapentadol or immediate release oxycodone. Hierarchical logistic regression models will be used to predict persistent opioid use, controlling for covariates including comorbidities. ETHICS AND DISSEMINATION Ethics approval has been obtained through the Monash University Human Research Ethics Committee (29977). We will present project findings in a peer-reviewed journal article, in accordance with the REporting of studies Conducted using Observational Routinely-collected health Data statement.
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Affiliation(s)
- Tina Lam
- Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia
| | | | - Ting Xia
- Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia
| | - John Evans
- Slade Pharmacy, Mount Waverley, Victoria, Australia
| | - Jennifer Stevens
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | | | - Dan I Lubman
- Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia
- Turning Point, Eastern Health Clinical School, Monash University, Richmond, Victoria, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia
- Turning Point, Eastern Health Clinical School, Monash University, Richmond, Victoria, Australia
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Xu M, Zhou M, Sun X, Shi X. Geographic variations in idiopathic epiretinal membranes in China. Ann Transl Med 2021; 9:938. [PMID: 34350253 PMCID: PMC8263892 DOI: 10.21037/atm-21-2722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/09/2021] [Indexed: 11/07/2022]
Abstract
Background Idiopathic epiretinal membranes (ERMs) often cause metamorphopsia and the progressive loss of central visual function, which seriously affect quality of life. We aimed to map the distribution pattern of idiopathic ERMs in China and to examine the factors affecting the surgical choices of multicenter surgeons. Methods A national ophthalmologist-oriented questionnaire was administered, applied with a multistage probability sampling method. Data of essential characteristics, including age, professional title, residence, and perioperative and postoperative care, were gathered. All the data are expressed as odds ratios (ORs) and 95% confidence intervals (CIs). The histogram and choropleth map were generated by Excel 2016. Results In total, 1,137 (85.2%) valid responses were returned with maximized response and completion rates. The study showed that monthly admission numbers, and preoperative and postoperative care varied significantly across different regions in China. Generally, the monthly patient admission numbers were lower in the Western region than the Eastern region. However, patients in the Eastern region had longer preoperative waiting periods and shorter hospital stays. Conclusions The epidemiology of idiopathic ERMs varied significantly across different regions in China. The distribution pattern of ERM in China and the overview of the factors affecting the surgery approaches of multicenter surgeons were shown. The findings of this study will contribute to the formulation of medical policies, and provide insights into the healthcare environments across China.
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Affiliation(s)
- Mengqiao Xu
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Fundus Disease, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Fundus Disease, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Fundus Disease, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Shi
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, China
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Li CY, Chuang YC, Chen PC, Chen MS, Lee MC, Ku LJE, Lee CB. Social Determinants of Diabetes-Related Preventable Hospitalization in Taiwan: A Spatial Analysis. Int J Environ Res Public Health 2021; 18:2146. [PMID: 33671762 PMCID: PMC7926970 DOI: 10.3390/ijerph18042146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Abstract
Diabetes-Related Preventable Hospitalization (DRPH) has been identified as an important indicator of efficiency and quality of the health system and can be modified by social determinants. However, the spatial disparities, clustering, and relationships between DRPH and social determinants have rarely been investigated. Accordingly, this study examined the association of DRPH with area deprivation, densities of certificated diabetes health-promoting clinics (DHPC) and hospitals (DHPH), and the presence of elderly social services (ESS) using both statistical and spatial analyses. Data were obtained from the 2010-2016 National Health Insurance Research Database (NHIRD) and government open data. Township-level ordinary least squares (OSL) and geographically weighted regression (GWR) were conducted. DRPH rates were found to be negatively associated with densities of DHPC (β = -66.36, p = 0.029; 40.3% of all townships) and ESS (β = -1.85, p = 0.027; 28.4% of all townships) but positively associated with area deprivation (β = 2.96, p = 0.002; 25.6% of all townships) in both OLS and GWR models. Significant relationships were found in varying areas in the GWR model. DRPH rates are high in townships of Taiwan that have lower DHPC densities, lower ESS densities, and greater socioeconomic deprivation. Spatial analysis could identify areas of concern for potential intervention.
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Affiliation(s)
- Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; (C.-Y.L.); (L.-J.E.K.)
| | - Yung-Chung Chuang
- Department of Urban Planning and Spatial Information, Feng Chia University, Taichung 407802, Taiwan;
| | - Pei-Chun Chen
- Department of Public Health, China Medical University, Taichung 40402, Taiwan;
| | - Michael S. Chen
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
- Department of Social Welfare and Center for Innovative Research on Aging Society, National Chung Cheng University, Chiayi 62102, Taiwan;
| | - Miaw-Chwen Lee
- Department of Social Welfare and Center for Innovative Research on Aging Society, National Chung Cheng University, Chiayi 62102, Taiwan;
| | - Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; (C.-Y.L.); (L.-J.E.K.)
| | - Chiachi Bonnie Lee
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan
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Lumme S, Manderbacka K, Arffman M, Karvonen S, Keskimaki I. Cumulative social disadvantage and hospitalisations due to ambulatory care-sensitive conditions in Finland in 2011─2013: a register study. BMJ Open 2020; 10:e038338. [PMID: 32847920 PMCID: PMC7451287 DOI: 10.1136/bmjopen-2020-038338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To study the interplay between several indicators of social disadvantage and hospitalisations due to ambulatory care-sensitive conditions (ACSC) in 2011─2013. To evaluate whether the accumulation of preceding social disadvantage in one point of time or prolongation of social disadvantage had an effect on hospitalisations due to ACSCs. Four common indicators of disadvantage are examined: living alone, low level of education, poverty and unemployment. DESIGN A population-based register study. SETTING Nationwide individual-level register data on hospitalisations due to ACSCs for the years 2011-2013 and preceding data on social and socioeconomic factors for the years 2006─2010. PARTICIPANTS Finnish residents aged 45 or older on 1 January 2011. OUTCOME MEASURE Hospitalisations due to ACSCs in 2011-2013. The effect of accumulation of preceding disadvantage in one point of time and its prolongation on ACSCs was studied using modified Poisson regression. RESULTS People with preceding cumulative social disadvantage were more likely to be hospitalised due to ACSCs. The most hazardous combination was simultaneously living alone, low level of education and poverty among the middle-aged individuals (aged 45-64 years) and the elderly (over 64 years). Risk ratio (RR) of being hospitalised due to ACSC was 3.16 (95% CI 3.03-3.29) among middle-aged men and 3.54 (3.36-3.73) among middle-aged women compared with individuals without any of these risk factors when controlling for age and residential area. For the elderly, the RR was 1.61 (1.57-1.66) among men and 1.69 (1.64-1.74) among women. CONCLUSIONS To improve social equity in healthcare, it is important to recognise not only patients with cumulative disadvantage but also-as this study shows-patients with particular combinations of disadvantage who may be more susceptible. The identification of these vulnerable patient groups is also necessary to reduce the use of more expensive treatment in specialised healthcare.
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Affiliation(s)
- Sonja Lumme
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kristiina Manderbacka
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Martti Arffman
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Sakari Karvonen
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Ilmo Keskimaki
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Pirkanmaa, Finland
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Cowdery SP, Sajjad MA, Holloway-Kew KL, Mohebbi M, Williams LJ, Kotowicz MA, Livingston PM, Khasraw M, Hakkennes S, Dunning TL, Brumby S, Page RS, Sutherland AG, Brennan-Olsen SL, Berk M, Campbell D, Pasco JA. Mapping Cancer incidence across Western Victoria: the association with age, accessibility, and socioeconomic status among men and women. BMC Cancer 2019; 19:892. [PMID: 31492163 PMCID: PMC6728959 DOI: 10.1186/s12885-019-6070-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/21/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Cancer is a leading burden of disease in Australia and worldwide, with incidence rates varying with age, sex and geographic location. As part of the Ageing, Chronic Disease and Injury study, we aimed to map the incidence rates of primary cancer diagnoses across western Victoria and investigate the association of age, accessibility/remoteness index of Australia (ARIA) and area-level socioeconomic status (SES) with cancer incidence. METHODS Data on cancer incidence in the study region were extracted from the Victorian Cancer Registry (VCR) for men and women aged 40+ years during 2010-2013, inclusive. The age-adjusted incidence rates (per 10,000 population/year), as well as specific incidence for breast, prostate, lung, bowel and melanoma cancers, were calculated for the entire region and for the 21 Local Government Areas (LGA) that make up the whole region. The association of aggregated age, ARIA and SES with cancer incidence rates across LGAs was determined using Poisson regression. RESULTS Overall, 15,120 cancer cases were identified; 8218 (54%) men and 6902 women. For men, the age-standardised rate of cancer incidence for the whole region was 182.1 per 10,000 population/year (95% CI 177.7-186.5) and for women, 162.2 (95% CI: 157.9-166.5). The incidence of cancer (overall) increased with increasing age for men and women. Geographical variations in cancer incidence were also observed across the LGAs, with differences identified between men and women. Residents of socioeconomically disadvantaged and less accessible areas had higher cancer incidence (p < 0.001). CONCLUSION Cancer incidence rates varied by age, sex, across LGAs and with ARIA. These findings not only provide an evidence base for identifying gaps and assessing the need for services and resource allocation across this region, but also informs policy and assists health service planning and implementation of preventative intervention strategies to reduce the incidence of cancer across western Victoria. This study also provides a model for further research across other geographical locations with policy and clinical practice implications, both nationally and internationally.
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Affiliation(s)
| | | | | | - Mohammadreza Mohebbi
- Faculty of Health, Deakin University, Geelong, Australia.,Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Australia
| | | | - Mark A Kotowicz
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,University Hospital Geelong, Barwon Health, Geelong, Australia
| | | | - Mustafa Khasraw
- School of Medicine, Deakin University, Geelong, Australia.,The University of Sydney, Sydney, Australia
| | | | - Trisha L Dunning
- Centre for Quality and Patient Safety Research, Barwon Health Partnership, School of Nursing and Midwifery, Deakin University Geelong, Hamilton, Australia
| | - Susan Brumby
- School of Medicine, Deakin University, Geelong, Australia.,National Centre for Farmer Health, Western District Health Service, Hamilton, Australia
| | - Richard S Page
- School of Medicine, Deakin University, Geelong, Australia.,University Hospital Geelong, Barwon Health, Geelong, Australia.,Barwon Centre for Orthopaedic Research and Education, Barwon Health and St John of God Hospitals, Geelong, Australia
| | - Alasdair G Sutherland
- School of Medicine, Deakin University, Geelong, Australia.,South West Healthcare, Warrnambool, Australia
| | - Sharon L Brennan-Olsen
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), St Albans, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, St Albans, Australia.,Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - David Campbell
- University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,University Hospital Geelong, Barwon Health, Geelong, Australia.,Department of Epidemiology and Preventive Health, Monash University, Melbourne, Australia
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