Feasibility and validity of using healthcare databases to conduct cross-national comparative studies of opioid use, its determinants and consequences

Teng-Chou Chen, Björn Wettermark, Douglas Steinke, Gillian E. Caughey, Mina Tadrous, Li-Chia Chen, Veronika J. Wirtz

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose
A cross-national comparative (CNC) study about opioid utilization would allow the identification of strategies to improve pain management and mitigate risk. However, little is known about the accessibility and validity of information in healthcare databases internationally. This study aimed to identify the feasibility of using healthcare databases to conduct a CNC study of opioid utilization and its associated consequences.

Methods
A cross-sectional survey was launched in March 2018, including experts interested in CNC studies comparing opioid utilization by purposeful sampling. An electronic survey was used to collect database characteristics, medicine information, and linkage information of each aggregate-level dataset (AD) and individual patient-level dataset (IPD).

Results
Overall, participants from 21 geographical regions reported 18 ADs and 19 IPDs. Information on dispensed medications is available from 17 ADs and 17 IPDs. Of the 16 ADs that include primary care settings, only 9 ADs can obtain information from secondary care settings. Fourteen IPDs included patients' characteristics or could be retrieved from linkage databases. Although most ADs are publicly accessible (n = 13), only five IPDs can be accessed without extra cost.

Conclusion
Most ADs could be used to report opioid utilization in a primary care setting. IPDs with linkage databases should be applied to identify potential determinants, clinical outcomes, and policy impact. Data access restrictions and governance policies across jurisdictions can be challenging for timely analysis and require further collaboration.
Original languageEnglish
Pages (from-to)1021
Number of pages1031
JournalPharmacoepidemiology & Drug Safety
Volume32
Issue number9
DOIs
Publication statusPublished - 21 Mar 2023

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