Publications (103) View all
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Article: Reimbursement of analgesics for chronic pain.
Tidsskrift for den Norske laegeforening 11/2012; 132(22):2489-2493. -
Article: Hypnotic drug use among 0-17 year olds during 2004-2011: A nationwide prescription database study.
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ABSTRACT: Aims: To (a) describe the prevalence, trend, and amount of hypnotic drug use, (b) determine the prevalence of chronic diseases among hypnotic drug users, and (c) determine levels of recurrent hypnotic drug use (2007-2011), among 0-17 year old Norwegians. Methods: Data were obtained from the nationwide Norwegian Prescription Database (NorPD) in the period 2004-2011. Results: Hypnotic drug use in 0-17 year olds increased during the period, from 8.9 to 12.3 per 1000, mainly owing to doubling of melatonin use. Hypnotic drug use peaked at 15 per 1000 among those aged 1-2 years. Melatonin use increased steadily from 6 to 12 years of age, most pronounced in males. Among females, hypnotic drug use increased threefold from 13 to17 years of age. Melatonin was dispensed in the highest annual amount of all hypnotic drugs; accounting up to a median of 360 defined daily doses in 9-13 year old boys. A total of 62% and 52% of all male and female hypnotic drug users were co-medicated with reimbursable drugs for chronic diseases. Levels of recurrent use (2007-2011) were 12% in boys and 8% in girls, of whom 76-77% were co-medicated with drugs reimbursed for chronic diseases. Conclusions: There is a trend of increasing use of hypnotic drugs among 0-17 year olds, mainly owing to increasing use of melatonin, used in high amounts. Still, melatonin is not recommended in Norway for use in this age group because of insufficient data on safety and efficacy. A threefold increase in hypnotic drugs among females from 13 to 17 years of age warrants attention.Scandinavian Journal of Public Health 10/2012; · 1.39 Impact Factor -
Article: Effects of preconceptional paternal drug exposure on birth outcomes: cohort study of 340,000 pregnancies using Norwegian population-based databases.
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ABSTRACT: AIMS: We aimed to explore associations between drugs dispensed to the father prior to conception and pregnancy outcomes such as preterm birth, perinatal mortality, foetal growth retardation and birth defects. METHODS: In this cohort study, two population-based registries, the Medical Birth Registry of Norway and the Norwegian Prescription Database, were linked. The study cohort consisted of 340,000 pregnancies in 2004-10. The association between specific drugs dispensed to the fathers during the last three months prior to conception and pregnancy outcomes were explored by estimating odds ratios (ORs) using multivariate logistic regression. RESULTS: About one quarter (26%) of the fathers were dispensed at least one drug during the last three months prior to conception, and 1.3% were dispensed at least one drug requiring special attention. Overall, the odds of different adverse pregnancy outcomes were not increased when the father had been dispensed drugs, i.e. the OR and confidence intervals (CIs) for any birth defect when the fathers had been dispensed any drug were 0.99 (0.94-1.0). When the fathers had been dispensed diazepam we found increased risk of perinatal mortality and growth retardation, with OR and CIs of 2.2 (1.2-3.9) and 1.4 (1.2-1.6), respectively. CONCLUSIONS: Large studies are necessary to reveal increased risk of rare outcomes as specific birth defects. Our study did not indicate that paternal drug exposure is an important risk factor for adverse pregnancy outcomes.British Journal of Clinical Pharmacology 08/2012; · 2.96 Impact Factor -
Article: Prescription drug use among pregnant women in opioid Maintenance Treatment.
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ABSTRACT: AIMS: This study describes the use of prescribed drugs among women in opioid maintenance treatment (OMT) prior to, and during, pregnancy. DESIGN: This cohort study was based on data from two nationwide databases: the Medical Birth Registry of Norway and the Norwegian Prescription Database. SETTING: Norway, 2004-2010. PARTICIPANTS: OMT drugs were dispensed to 138 women with 159 pregnancies. MEASUREMENTS: All prescription drugs dispensed to women in OMT three months prior to, and during, pregnancy were studied. Amounts of benzodiazepines, z-hypnotics and opioid analgesics dispensed during pregnancy were studied and bivariate analysis was used to study neonatal outcomes of OMT pregnancies with and without such co-medication. FINDINGS: The prevalence of prescription drug use by pregnant OMT women was high both during the three-month period prior to (69%), and during (81%), pregnancy. The proportion of pregnant women that was dispensed anti-infectives (48%) and/or drugs acting on the nervous system (45%) during any time in pregnancy was especially high. In 21%, 15% and 13% of the pregnancies the women were dispensed benzodiazepine anxiolytics, opioid analgesics or benzodiazepine hypnotics respectively. Only 5% of the OMT women were dispensed antidepressants. Malformations were significantly more common among children born to mothers in OMT that received co-medication with opioids, benzodiazepines or z-hypnotics. CONCLUSIONS: A higher proportion of women in opioid maintenance treatment in Norway use prescription drugs prior to, and during, pregnancy than pregnant women in the general population. Co-medication with drugs with abuse potential may increase the risk of adverse pregnancy outcomes and this need to be further addressed.Addiction 08/2012; · 4.31 Impact Factor -
Article: Neonatal outcomes following in utero exposure to methadone or buprenorphine: A National Cohort Study of opioid-agonist treatment of Pregnant Women in Norway from 1996 to 2009.
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ABSTRACT: BACKGROUND: In Norway, most opioid-dependent women are in opioid maintenance treatment (OMT) with either methadone or buprenorphine throughout pregnancy. The inclusion criteria for both medications are the same and both medications are provided by the same health professionals in any part of the country. International studies comparing methadone and buprenorphine in pregnancy have shown differing neonatal outcomes for the two medications. METHOD: This study compared the neonatal outcomes following prenatal exposure to either methadone or buprenorphine in a national clinical cohort of 139 women/neonates from 1996 to 2009. RESULTS: After adjusting for relevant covariates, buprenorphine-exposed newborns had larger head circumferences and tended to be heavier and longer than methadone-exposed newborns. The incidence of neonatal abstinence syndrome (NAS) and length of treatment of NAS did not differ between methadone- and buprenorphine-exposed newborns. There was little use of illegal drugs and benzodiazepines during the pregnancies. However, the use of any drugs or benzodiazepines during pregnancy was associated with longer lasting NAS-treatment of the neonates. CONCLUSIONS: The clinical relevance of these findings is that both methadone and buprenorphine are acceptable medications for the use in pregnancy, in line with previous studies. If starting OMT in pregnancy, buprenorphine should be considered as the drug of choice, due to more favorable neonatal growth parameters. Early confirmation of the pregnancy and systematic follow-up throughout the pregnancy are of importance to encourage the women in OMT to abstain from the use of tobacco, alcohol, illegal drugs or misuse of prescribed drugs.Drug and alcohol dependence 07/2012; · 3.60 Impact Factor
