Medicines Intelligence (MedIntel) Data Platform

Summary

The Medicines Intelligence (MedIntel) Data Platform is a new linked data resource established to generate evidence on prescribed medicine use, safety, costs, and cost-effectiveness in Australia. It adheres to best practice privacy principles, with no identifying information available to researchers. The platform comprises Medicare-eligible people who are ≥18 years and residing in New South Wales (NSW), Australia, any time during 2005-2020, with linked data on dispensed prescription medicines, Medicare services, emergency department visits, hospitalisations, cancer notifications, and deaths. In total, the platform includes 7.4 million unique people across all years, covering 36.9% of the Australian adult population. As of 1 January 2019 (the last pre-pandemic year), the cohort had a mean age of 48.7 years (51.1% female), with most people (4.4M, 74.7%) residing in a major city. In 2019, 4.4M people (73.3%) were dispensed a medicine (most commonly anti-infective, nervous system, and cardiovascular medicines), 1.2M (20.5%) were hospitalised, 5.3M (89.4%) had a GP or specialist appointment, and 54 003 people died. Data are available until 2022 with approval for annual updates. This platform creates opportunities for national and international research collaborations and enables us to address important questions about quality use of medicines and health outcomes.

Zoega, H., Falster, M., Gillies, M., Litchfield, M., Camacho, X., Bruno, C., Daniels, B., Donnolley, N., Havard, A., Schaffer, A., Chambers, G., Degenhardt, L., Dobbins, T., Gisev, N., Ivers, R., Jorm, L., Liu, B., Vajdic, C. and Pearson, S.-A. (2024), The Medicines Intelligence Data Platform: A Population-Based Data Resource From New South Wales, Australia. Pharmacoepidemiol Drug Saf, 33: e5887. https://doi.org/10.1002/pds.5887

Summary

In our study, we looked at the use of new medicines for Type 2 diabetes: SGLT2 inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP-1RAs) in New South Wales. These medicines, taken with traditional diabetes medicines significantly improve blood sugar levels, and reduce the risk of heart and kidney disease. We found only half of patients who were using traditional diabetes medicines also used SGLT2is, and approximately 15% used GLP-1RAs. Importantly, patterns of use varied depending on where people lived. SGLT2is were less commonly used in regions where people have lower incomes and poorer health. One area in north-east NSW showed higher GLP-1RA use than other regions. To increase the use of these highly effective medicines, we recommend lowering costs to patients, changing restrictions on who is eligible to access them, and educating care providers about their benefits for patients. Monitoring medicine use by where people live allows us to focus interventions in specific locations to maximise use in people who will benefit the most. For researchers, our findings highlight the importance of considering local prescribing patterns when exploring medicine use across geographies (e.g. urban and regional area) - as these can overshadow any broader trends observed.

de Oliveira Costa, J., Lin, J., Milder, T. Y., Greenfield, J. R., Day, R. O., Stocker, S. L., Neuen, B. L., Havard, A., Pearson, S. A., & Falster, M. O. (2024). Geographic variation in sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide-1 receptor agonist use in people with type 2 diabetes in New South Wales, Australia. Diabetes Obes Metab. https://doi.org/10.1111/dom.15597 

Summary

Prescription medicines for strong pain relief known as opioids, such as oxycodone, morphine, or tramadol, are an important tool for reducing moderate to severe pain in the short-term and are often prescribed when patients have been discharged from a hospital or Emergency Department visit. However, they also have significant side effects, particularly when used for a long time. Until recently, Australia’s use of prescription opioids was increasing, and with it worries about dependence, overdose and death. Because of this, we were interested in looking at how often people continue using these medicines in NSW long-term (more than 90 days) after leaving hospital.

Our study was the first whole-of-population Australian study to estimate long-term opioid use following Emergency Department presentations and hospital admissions. The study used non-identifiable health data to follow all hospitalisations and Emergency Department visits in NSW between 2014-2020. We found that during this period, the overall number of people starting opioids for the first time decreased by 16%, from 8.7% to 7.2% of hospital/Emergency Department visits. Long-term opioid use decreased by 33%, from 1.3% to 0.8%.

Other important findings were about the use of these painkillers after visiting a hospital for different reasons. For example, the study found that one in four people admitted for traumatic injuries, like a physical injury or road accident, started an opioid and 2.3% of them went on to long-term use. This rate of long-term use is somewhat lower than reported in previous Australian research. We also found one in 15 people attending an ED started an opioid and only 1.0% of them went on to long-term use - lower than estimates from the US. 

Insights from such large studies like ours inform opioid prescribing policies in hospitals and promote quality prescribing practices. 

Gillies MB, Chidwick K, Bharat C, Camacho X, Currow D, Gisev N, Degenhardt L, Pearson, S-A. Long-term prescribed opioid use after hospitalization or emergency department presentation among opioid naïve adults (2014–2020)—A population-based descriptive cohort study. Br J Clin Pharmacol. 2024; 1-13. doi: https://doi.org/10.1111/bcp.16093