Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis.Citation formats

  • External authors:
  • Keith Hawton
  • Helen Bergen
  • Sue Simkin
  • Anita Brock
  • Clare Griffiths
  • Ester Romeri
  • Karen L Smith
  • David Gunnell

Standard

Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis. / Hawton, Keith; Bergen, Helen; Simkin, Sue; Brock, Anita; Griffiths, Clare; Romeri, Ester; Smith, Karen L; Kapur, Navneet; Gunnell, David.

In: Bmj, Vol. 338, 2009.

Research output: Contribution to journalArticle

Harvard

Hawton, K, Bergen, H, Simkin, S, Brock, A, Griffiths, C, Romeri, E, Smith, KL, Kapur, N & Gunnell, D 2009, 'Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis.', Bmj, vol. 338. https://doi.org/10.1136/bmj.b2270

APA

Hawton, K., Bergen, H., Simkin, S., Brock, A., Griffiths, C., Romeri, E., ... Gunnell, D. (2009). Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis. Bmj, 338. https://doi.org/10.1136/bmj.b2270

Vancouver

Author

Hawton, Keith ; Bergen, Helen ; Simkin, Sue ; Brock, Anita ; Griffiths, Clare ; Romeri, Ester ; Smith, Karen L ; Kapur, Navneet ; Gunnell, David. / Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis. In: Bmj. 2009 ; Vol. 338.

Bibtex

@article{4246c619fd434ea7875d96189f2f56f0,
title = "Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis.",
abstract = "OBJECTIVE: To assess the effect of the UK Committee on Safety of Medicines' announcement in January 2005 of withdrawal of co-proxamol on analgesic prescribing and poisoning mortality. DESIGN: Interrupted time series analysis for 1998-2007. SETTING: England and Wales. DATA SOURCES: Prescribing data from the prescription statistics department of the Information Centre for Health and Social Care (England) and the Prescribing Services Unit, Health Solutions Wales (Wales). Mortality data from the Office for National Statistics. MAIN OUTCOME MEASURES: Prescriptions. Deaths from drug poisoning (suicides, open verdicts, accidental poisonings) involving single analgesics. RESULTS: A steep reduction in prescribing of co-proxamol occurred in the post-intervention period 2005-7, such that number of prescriptions fell by an average of 859 (95{\%} confidence interval 653 to 1065) thousand per quarter, equating to an overall decrease of about 59{\%}. Prescribing of some other analgesics (co-codamol, paracetamol, co-dydramol, and codeine) increased significantly during this time. These changes were associated with a major reduction in deaths involving co-proxamol compared with the expected number of deaths (an estimated 295 fewer suicides and 349 fewer deaths including accidental poisonings), but no statistical evidence for an increase in deaths involving either other analgesics or other drugs. CONCLUSIONS: Major changes in prescribing after the announcement of the withdrawal of co-proxamol have had a marked beneficial effect on poisoning mortality involving this drug, with little evidence of substitution of suicide method related to increased prescribing of other analgesics.",
keywords = "poisoning: Acetaminophen, poisoning: Analgesics, poisoning: Dextropropoxyphene, legislation & jurisprudence: Drug Approval, Drug Combinations, epidemiology: England, Humans, trends: Mortality, mortality: Poisoning, poisoning: Prescription Drugs, statistics & numerical data: Suicide, epidemiology: Wales",
author = "Keith Hawton and Helen Bergen and Sue Simkin and Anita Brock and Clare Griffiths and Ester Romeri and Smith, {Karen L} and Navneet Kapur and David Gunnell",
note = ", Department of Health, United Kingdom",
year = "2009",
doi = "10.1136/bmj.b2270",
language = "English",
volume = "338",
journal = "B M J",
issn = "0959-535X",
publisher = "BMJ",

}

RIS

TY - JOUR

T1 - Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis.

AU - Hawton, Keith

AU - Bergen, Helen

AU - Simkin, Sue

AU - Brock, Anita

AU - Griffiths, Clare

AU - Romeri, Ester

AU - Smith, Karen L

AU - Kapur, Navneet

AU - Gunnell, David

N1 - , Department of Health, United Kingdom

PY - 2009

Y1 - 2009

N2 - OBJECTIVE: To assess the effect of the UK Committee on Safety of Medicines' announcement in January 2005 of withdrawal of co-proxamol on analgesic prescribing and poisoning mortality. DESIGN: Interrupted time series analysis for 1998-2007. SETTING: England and Wales. DATA SOURCES: Prescribing data from the prescription statistics department of the Information Centre for Health and Social Care (England) and the Prescribing Services Unit, Health Solutions Wales (Wales). Mortality data from the Office for National Statistics. MAIN OUTCOME MEASURES: Prescriptions. Deaths from drug poisoning (suicides, open verdicts, accidental poisonings) involving single analgesics. RESULTS: A steep reduction in prescribing of co-proxamol occurred in the post-intervention period 2005-7, such that number of prescriptions fell by an average of 859 (95% confidence interval 653 to 1065) thousand per quarter, equating to an overall decrease of about 59%. Prescribing of some other analgesics (co-codamol, paracetamol, co-dydramol, and codeine) increased significantly during this time. These changes were associated with a major reduction in deaths involving co-proxamol compared with the expected number of deaths (an estimated 295 fewer suicides and 349 fewer deaths including accidental poisonings), but no statistical evidence for an increase in deaths involving either other analgesics or other drugs. CONCLUSIONS: Major changes in prescribing after the announcement of the withdrawal of co-proxamol have had a marked beneficial effect on poisoning mortality involving this drug, with little evidence of substitution of suicide method related to increased prescribing of other analgesics.

AB - OBJECTIVE: To assess the effect of the UK Committee on Safety of Medicines' announcement in January 2005 of withdrawal of co-proxamol on analgesic prescribing and poisoning mortality. DESIGN: Interrupted time series analysis for 1998-2007. SETTING: England and Wales. DATA SOURCES: Prescribing data from the prescription statistics department of the Information Centre for Health and Social Care (England) and the Prescribing Services Unit, Health Solutions Wales (Wales). Mortality data from the Office for National Statistics. MAIN OUTCOME MEASURES: Prescriptions. Deaths from drug poisoning (suicides, open verdicts, accidental poisonings) involving single analgesics. RESULTS: A steep reduction in prescribing of co-proxamol occurred in the post-intervention period 2005-7, such that number of prescriptions fell by an average of 859 (95% confidence interval 653 to 1065) thousand per quarter, equating to an overall decrease of about 59%. Prescribing of some other analgesics (co-codamol, paracetamol, co-dydramol, and codeine) increased significantly during this time. These changes were associated with a major reduction in deaths involving co-proxamol compared with the expected number of deaths (an estimated 295 fewer suicides and 349 fewer deaths including accidental poisonings), but no statistical evidence for an increase in deaths involving either other analgesics or other drugs. CONCLUSIONS: Major changes in prescribing after the announcement of the withdrawal of co-proxamol have had a marked beneficial effect on poisoning mortality involving this drug, with little evidence of substitution of suicide method related to increased prescribing of other analgesics.

KW - poisoning: Acetaminophen

KW - poisoning: Analgesics

KW - poisoning: Dextropropoxyphene

KW - legislation & jurisprudence: Drug Approval

KW - Drug Combinations

KW - epidemiology: England

KW - Humans

KW - trends: Mortality

KW - mortality: Poisoning

KW - poisoning: Prescription Drugs

KW - statistics & numerical data: Suicide

KW - epidemiology: Wales

U2 - 10.1136/bmj.b2270

DO - 10.1136/bmj.b2270

M3 - Article

VL - 338

JO - B M J

JF - B M J

SN - 0959-535X

ER -