{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:30:13Z","timestamp":1792654213124,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T00:00:00Z","timestamp":1686528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007543","name":"Agence Nationale de S\u00e9curit\u00e9 du M\u00e9dicament et des Produits de Sant\u00e9","doi-asserted-by":"publisher","award":["EUPAS24364"],"award-info":[{"award-number":["EUPAS24364"]}],"id":[{"id":"10.13039\/501100007543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to present the first nation\u2010wide, systematic, repeated assessment of doctor\u2010shopping (i.e. visiting multiple physicians to be prescribed the same drug) during 10\u00a0years for more than 200 psychoactive prescription drugs in the 67 million inhabitants in France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a nation\u2010wide, repeated cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Participants<\/jats:title><jats:p>Data are from the French National Health Data System in 2010, 2015 and 2019 for 214 psychoactive prescription drugs (i.e. anaesthetics, analgesics, antiepileptics, anti\u2010Parkinson drugs, psycholeptics, psychoanaleptics, other nervous system drugs and antihistamines for systemic use).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The detection and quantification of doctor\u2010shopping relied upon an algorithm that detects overlapping prescriptions from repeated visits to different physicians. We used two doctor\u2010shopping indicators aggregated at population level for each drug dispensed to more than 5000 patients: (i) the quantity doctor\u2010shopped, expressed in defined daily doses (DDD), which measures the total quantity doctor\u2010shopped by the study population for a given drug; and (ii) the proportion doctor\u2010shopped, expressed as a percentage, which standardizes the quantity doctor\u2010shopped according to the use level of the drug.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The analyses included approximately 200 million dispensings to approximately 30 million patients each year. Opioids (e.g. buprenorphine, methadone, morphine, oxycodone and fentanyl), benzodiazepines and non\u2010benzodiazepine hypnotics (Z\u2010drugs) (e.g. diazepam, oxazepam, zolpidem and clonazepam) had the highest proportions doctor\u2010shopped during the study period. In most cases, the proportion and the quantity doctor\u2010shopped increased for opioids and decreased for benzodiazepines and Z\u2010drugs. Pregabalin had the sharpest increase in the proportion doctor\u2010shopped (from 0.28 to 1.40%), in parallel with a sharp increase in the quantity doctor\u2010shopped (+843%, from 0.7 to 6.6\u00a0DDD\/100\u2009000 inhabitants\/day). Oxycodone had the sharpest increase in the quantity doctor\u2010shopped (+1000%, from 0.1 to 1.1\u00a0DDD\/100\u2009000 inhabitants\/day), in parallel with a sharp increase in the proportion doctor\u2010shopped (from 0.71 to 1.41%). Detailed results for all drugs during the study period can be explored interactively at: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/soeiro.gitlab.io\/megadose\/\">https:\/\/soeiro.gitlab.io\/megadose\/<\/jats:ext-link>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In France, doctor\u2010shopping occurs for many drugs from many pharmacological classes, and mainly involves opioid maintenance drugs, some opioids analgesics, some benzodiazepines and Z\u2010drugs and pregabalin.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16261","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T10:04:45Z","timestamp":1684490685000},"page":"1984-1993","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Systematic assessment of non\u2010medical use of prescription drugs using doctor\u2010shopping indicators: A nation\u2010wide, 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