Impact of Safety-Related Regulations on Codeine Use in Children: A Quasi-Experimental Study Using Taiwan’s National Health Insurance Research Database
| العنوان: | Impact of Safety-Related Regulations on Codeine Use in Children: A Quasi-Experimental Study Using Taiwan’s National Health Insurance Research Database |
|---|---|
| المؤلفون: | Fei-Yuan Hsiao, Ching-Huan Wang, Chih-Wan Lin, Wei-I Huang, Wen-Wen Chen, Wei-Ming Ke, Pi-Hui Chao |
| المصدر: | Drug Safety. 40:615-627 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, Adolescent, Databases, Factual, National Health Programs, Taiwan, Pharmacology, Toxicology, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Environmental health, Humans, Medicine, Pharmacology (medical), 030212 general & internal medicine, Practice Patterns, Physicians', Medical prescription, Child, Adverse effect, Respiratory Tract Infections, Reimbursement, Codeine, business.industry, Infant, Respiratory infection, Odds ratio, Legislation, Drug, Drug Utilization, Confidence interval, Cough, Child, Preschool, Female, business, medicine.drug |
| الوصف: | Safety concerns regarding potential life-threatening adverse events associated with codeine have resulted in policy decisions to restrict its use in pediatrics. However, whether these drug safety communications have had an immediate and strong impact on codeine use remains in question. We aimed to investigate the impact of the two implemented safety-related regulations (label changes and reimbursement regulations) on the use of codeine for upper respiratory infection (URI) or cough. A quasi-experimental study was performed using Taiwan’s National Health Insurance Research Database. Quarterly data of codeine prescription rates for URI/cough visits were reported, and an interrupted time series design was used to assess the impact of the safety regulations on the uses of codeine among children with URI/cough visits. Multivariable logistic regression models were used to explore patient and provider characteristics associated with the use of codeine. The safety-related regulations were associated with a significant reduction in codeine prescription rates of −4.24% (95% confidence interval [CI] −4.78 to −3.70), and the relative reduction compared with predicted rates based on preregulation projections was 60.4, 56.6, and 53.2% in the first, second, and third year after the regulations began, respectively. In the postregulation period, physicians specializing in otolaryngology (odds ratio [OR] 1.47, 95% CI 1.45–1.49), practicing in district hospitals (OR 6.84, 95% CI 5.82–8.04) or clinics (OR 6.50, 95% CI 5.54–7.62), and practicing in the least urbanized areas (OR 1.60, 95% CI 1.55–1.64) were more likely to prescribe codeine to children than their counterparts. Our study provides a successful example of how to effectively reduce the codeine prescriptions in children in the ‘real-world’ settings, and highlights areas where future effort could be made to improve the safety use of codeine. Future research is warranted to explore whether there was a simultaneous decrease in the incidence rates of codeine-related adverse events following the safety-related regulations. |
| تدمد: | 1179-1942 0114-5916 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6357faeeec3298803809a371a8bd6eb0 https://doi.org/10.1007/s40264-017-0524-3 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....6357faeeec3298803809a371a8bd6eb0 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 11791942 01145916 |
|---|