POPPY II Cohort Profile– a population-based linked cohort examining the patterns and outcomes of prescription opioid use in NSW, Australia, 2003-2018
Presenter: Natasa Gisev
Introduction: Opioid prescribing and harms have increased in Australia in the past two decades. However, there is a lack of population-level evidence about the drivers of long-term prescribed opioid use, dependence, overdose and other harms. POPPY II is a retrospective population-based linked cohort developed to examine the patterns and outcomes of prescribed opioid use in New South Wales (NSW), Australia.
Aims: This study aimed to profile the POPPY II cohort with respect to sociodemographic and clinical health characteristics and patterns of opioid initiation.
Methods: Methods: The POPPY II cohort includes adult residents (≥18 years) in NSW who were initiated on prescribed opioids subsidised through Australia’s Pharmaceutical Benefits Scheme for any period between 1st July 2003 and 31st December 2018. The cohort has been linked to nine other datasets containing information on socio-demographic and clinical characteristics, health service use, and adverse outcomes. To account for changes in data capture for subsidised medicines over this time, a sub-cohort of those who initiated prescribed opioids between 1st July 2013 and 31st December 2018 was also constructed.
Results: Results: There were 3,569,433 people in the overall cohort and 2,578,596 in the sub-cohort of those initiating opioids between 2013-2018. One in four people were aged ≥65 years at the time of opioid initiation (26.8% overall cohort; 26.0% sub-cohort) and half were female (52.7%; 52.4%). Approximately 6% had evidence of being treated for cancer in the year prior to opioid initiation (5.8%; 5.4%). Less than a third initiated on a strong opioid (22.2%; 29.6%) and the most commonly initiated opioid was paracetamol/codeine (61.3%; 57.9%).
Implications: Implications: The POPPY II study is the largest post-marketing surveillance study of prescribed opioids in Australia, and one of the largest studies worldwide. Understanding the characteristics of the cohort will inform future work aimed at generating robust evidence of the course and outcomes of prescribed opioid use in the Australian community.