International Journal of Clinical Pharmacy

, Volume 39, Issue 4, pp 874–880 | Cite as

Opioid analgesic use in Australia and The Netherlands: a cross-country comparison

  • Francisca N. Wagemaakers
  • Samantha A. Hollingworth
  • Sanne Kreijkamp-Kaspers
  • Ernest H. L. Tee
  • Anne J. Leendertse
  • Mieke L. van DrielEmail author
Research Article


Background Increasing use of opioid analgesics (OA) has been reported worldwide. Objective To compare the use of OA in two countries in order to better understand these trends. Setting Outpatient settings in Australia and The Netherlands. Method We analysed publicly available government data on outpatient OA dispensing over 15 years (2000–2014). We compared dispensing trends for specific OA and explored medical (national clinical guidelines), contextual and policy-related factors to explain differences in use between the two countries. Main outcome measure OA prescribing in Australia and The Netherlands, absolute volume of use, preferred types of opioids and changes over time. Results The average annual increase in OA prescribing was 10% in Australia and 8% in The Netherlands between 2000 and 2014. In 2014, the total use of OA was 10.0 daily defined doses (DDD)/1000 population/day in Australia and 9.4 DDD/1000 population/day in The Netherlands. In Australia, the most commonly prescribed opioids were oxycodone and tramadol, compared to fentanyl and tramadol in The Netherlands. We found differences in prescribing guidelines, culture of prescribing and regulatory frameworks that could explain some of the observed differences. Conclusion OA prescribing has increased remarkably in both countries between 2000 and 2014 but the types of prescribed OA vary. Differences in national evidence-based guidelines influenced the types of OA used. Prescribing culture as well as regulatory policies and costs, may also contribute to the different patterns of OA use.


Analgesic Australia Guidelines Opioids Pain Pharmacoepidemiology Prescribing The Netherlands 



We thank the Australian Government Department of Health and the Dutch National Health Care Institute for providing freely accessible data on medicine dispensing.


Francisca Wagemaakers was granted a UMC Utrecht Internationalization Committee Grant for strategic network development.

Conflicts of interest

All authors declare that they have no conflict of interest.

Supplementary material

11096_2017_492_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 18 kb)


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Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Francisca N. Wagemaakers
    • 1
  • Samantha A. Hollingworth
    • 2
  • Sanne Kreijkamp-Kaspers
    • 3
  • Ernest H. L. Tee
    • 3
  • Anne J. Leendertse
    • 1
  • Mieke L. van Driel
    • 3
    Email author
  1. 1.Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
  2. 2.School PharmacyUniversity of QueenslandBrisbaneAustralia
  3. 3.Primary Care Clinical Unit, Faculty of MedicineUniversity of QueenslandBrisbaneAustralia

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