Background
Methods
Study Design
Data Sources
Study Population
Follow-Up Duration
Operational Definitions
Injury Severity
Pain Medication Prescription
Pain Medication Dose
Morphine Equivalent Dose (MED)
Treatment Days
Direct Health Care Costs of Pain Medication
Statistical Analysis
Figures and Tables
Results
Baseline Characteristics
Injury with ≥ 1 pain medication | Paracetamol | Metamizole | NSAID | Coxibs | Opioid (weak) | Opioid (strong) | |
---|---|---|---|---|---|---|---|
Cases n: (%) | 1,921,382 (100) | 889,703 (100) | 283,077 (100) | 1,632,984 (100) | 23,776 (100) | 194,539 (100) | 43,610 (100) |
Male: n (%) | 1,526,487 (79.4) | 704,710 (79.2) | 222,471 (78.6) | 1,305,735 (80.0) | 17,603 (74.0) | 155,153 (79.8) | 35,675 (81.8) |
Age groups | |||||||
18 to < 30 years: n (%) | 666,397 (34.7) | 298,013 (33.5) | 84,583 (29.9) | 568,458 (34.8) | 4076 (17.1) | 44,536 (22.9) | 12,771 (29.3) |
30 to < 45 years: n (%) | 618,084 (32.2) | 291,322 (32.7) | 90,508 (32.0) | 530,124 (32.5) | 7594 (31.9) | 67,462 (34.7) | 13,678 (31.4) |
45 to 65 years: n (%) | 636,901 (33.1) | 300,368 (33.8) | 107,986 (38.1) | 534,402 (32.7) | 12,106 (50.9) | 82,541 (42.4) | 17,161 (39.4) |
Total expenses (CHF)* | 57,759,797 | 13,781,635 | 2,670,406 | 31,349,719 | 1,839,853 | 5,650,660 | 2,467,523 |
Average expenses per case (CHF) | 30.06 | 15.49 | 9.43 | 19.20 | 77.38 | 29.05 | 56.58 |
Average expenses per treatment day (CHF) | 0.98 | 0.85 | 1.29 | 0.88 | 1.42 | 2.00 | 5.70 |
MED total: mg | 164,269,449 | N/A | N/A | N/A | N/A | 123,886,641 | 40,382,808 |
MED per case: mg | 85.5 | N/A | N/A | N/A | N/A | 636.8 | 926.0 |
Treatment days total | 58,723,907 | 16,294,133 | 2,073,578 | 35,799,186 | 1,294,949 | 2,828,846 | 433,215 |
Treatment days per case | 30.6 | 18.3 | 7.3 | 21.9 | 54.5 | 14.5 | 9.9 |
Changes in Medication Use and Costs Over Time
Year | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | % change 2008–2018 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Injury with ≥ 1 pain medication | 163,183 | 166,574 | 174,273 | 174,044 | 176,417 | 178,249 | 178,507 | 177,132 | 175,465 | 179,091 | 178,447 | + 9.4 |
Paracetamol | 67,710 | 72,758 | 78,226 | 79,671 | 81,409 | 84,214 | 84,746 | 84,208 | 84,473 | 85,578 | 86,710 | + 28.1 |
Rate/1000 injuries | 414.9 | 436.8 | 448.9 | 457.8 | 461.5 | 472.5 | 474.8 | 475.4 | 481.4 | 477.9 | 485.9 | + 17.1 |
Metamizole | 11,152 | 14,138 | 17,240 | 20,177 | 23,392 | 25,878 | 28,607 | 31,493 | 33,955 | 37,544 | 39,501 | + 254 |
Rate/1000 injuries | 68.3 | 84.9 | 98.9 | 115.9 | 132.6 | 145.2 | 160.3 | 177.8 | 193.5 | 209.6 | 221.4 | + 224 |
NSAID* | 139,857 | 142,056 | 147,895 | 148,860 | 149,997 | 151,503 | 151,909 | 150,786 | 148,761 | 151,772 | 150,588 | + 7.7 |
Rate/1000 injuries | 857.1 | 852.8 | 848.6 | 855.3 | 850.2 | 850.0 | 851.0 | 851.3 | 847.8 | 847.5 | 843.9 | − 1.54 |
Coxibs | 1425 | 1582 | 2077 | 2084 | 2214 | 2316 | 2271 | 2334 | 2209 | 2616 | 2648 | + 85.8 |
Rate/1000 injuries | 8.7 | 9.5 | 11.9 | 12.0 | 12.6 | 13.0 | 12.7 | 13.2 | 12.6 | 14.6 | 14.8 | + 70.1 |
Weak opioids | 16,062 | 17,018 | 18,332 | 17,671 | 18,118 | 18,499 | 17,767 | 17,730 | 17,303 | 18,243 | 17,796 | + 10.8 |
Rate/1000 injuries | 98.4 | 102.2 | 105.2 | 101.5 | 102.7 | 103.8 | 99.5 | 100.1 | 98.6 | 101.9 | 99.7 | + 1.32 |
Strong opioids | 2854 | 3057 | 3346 | 3535 | 3635 | 3822 | 4017 | 4411 | 4497 | 5059 | 5377 | + 88.4 |
Rate/1000 injuries | 17.5 | 18.4 | 19.2 | 20.3 | 20.6 | 21.4 | 22.5 | 24.9 | 25.6 | 28.3 | 30.1 | + 72 |
Year | 2008 Cases | 2018 Cases | % change 2008–18 | Treatment days per case 2008 | Treatment days per case 2018 | % change 2008–2018 | Costs per treatment day 2008 | Costs per treatment day 2018 | % change 2008–2018 |
---|---|---|---|---|---|---|---|---|---|
Minor injuries | 49,167 | 51,724 | + 5.2 | 15.2 | 18.7 | + 22.8 | 1.05 | 0.78 | − 25.6 |
Paracetamol | 13,580 | 17,084 | + 25.8 | 9.7 | 13.7 | + 41.2 | 0.86 | 0.62 | − 27.3 |
Metamizole | 1137 | 5579 | + 390.6 | 3.8 | 5.8 | + 51.1 | 1.52 | 1.08 | − 28.9 |
NSAID* | 41,503 | 42,885 | + 3.3 | 14.0 | 15.3 | + 9.5 | 1.05 | 0.78 | − 25.8 |
Coxibs | 213 | 459 | + 115.5 | 44.4 | 41.3 | − 6.9 | 1.47 | 1.22 | − 17.1 |
Weak opioids | 2052 | 1922 | − 6.3 | 10.0 | 11.5 | + 14.8 | 2.07 | 1.58 | − 23.3 |
Strong opioids | 116 | 222 | + 91.4 | 6.0 | 5.1 | − 15.7 | 1.79 | 5.22 | + 192.4 |
Major injuries | 114,016 | 126,723 | + 11.1 | 32.1 | 38.1 | + 18.8 | 1.17 | 0.87 | − 25.5 |
Paracetamol | 54,130 | 69,626 | + 28.6 | 16.8 | 20.9 | + 24.6 | 1.06 | 0.74 | − 29.7 |
Metamizole | 10,015 | 33,922 | + 238.7 | 6.0 | 8.9 | + 48.2 | 1.67 | 1.12 | − 32.8 |
NSAID | 98,354 | 107,703 | + 9.5 | 24.0 | 25.0 | + 4.0 | 1.03 | 0.76 | − 26.6 |
Coxibs | 1212 | 2189 | + 80.6 | 64.2 | 55.0 | − 14.3 | 1.54 | 1.26 | − 17.8 |
Weak opioids | 14,010 | 15,874 | + 13.3 | 15.8 | 14.1 | − 10.7 | 2.41 | 1.63 | − 32.6 |
Strong opioids | 2738 | 5155 | + 88.3 | 12.1 | 8.1 | − 32.8 | 4.52 | 6.06 | + 34.0 |