Analgesic Prescribing Trends of Opioids, Nonsteroidal Anti-Inflammatory Drugs, and Paracetamol in Taiwan (2001-2020): Age-Period-Cohort Cross-Sectional Study
Abstract
Background: Despite ongoing global changes in analgesic prescribing practices, long-term trends accounting for age, period, and cohort effects remain poorly understood in Asian populations, where opioid and nonopioid prescribing trajectories differ from those observed in Western nations.
Objective: This study aimed to examine the long-term prescribing trends of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and paracetamol in Taiwan by age, calendar period, and birth cohort using an age-period-cohort (APC) framework.
Methods: We conducted a population-based repeated cross-sectional study using Taiwan National Health Insurance claims data (2001-2020). The cohort included all insured individuals aged 1 to 85 years, with an annual population size of 22.3 to 23.1 million. Exposure variables were structured for APC modeling, comprising 5-year age groups, four 5-year calendar periods (2001-2020), and 5-year birth cohorts (1920-1924 to 2015-2019).
Results: Opioid prescribing prevalence escalated from 123.66 per 100,000 persons in 2001 to 2005 to 706.93 in 2016 to 2020. APC analysis showed a significant positive net drift for opioids (+10.93% per year, 95% CI 10.36%-11.51%; P<.001). The estimated magnitude of the opioid prescribing increase was sensitive to the prescription frequency threshold used. In contrast, paracetamol and NSAIDs showed overall declines (net drifts: -2.44%, 95% CI -2.58% to -2.29%, and -0.82%, 95% CI -0.97% to -0.66%, respectively). Notably, local…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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