{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:18:43Z","timestamp":1747185523665,"version":"3.40.5"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Codeine\u2010containing compound analgesics (CCCAs) are associated with dependence and, when taken in excess, significant risks of harm. A previous audit showed significant costs related to admissions for gastrointestinal (GI) complications of CCCA. Based on this and other evidence of harm, the Australian Therapeutic Goods Administration changed CCCAs to prescription only in 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to identify the costs associated with codeine\u2010related GI complications and whether the schedule change in 2018 led to a reduced clinical and financial strain on the health care system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted an audit of GI admissions and associated costs of CCCAs at a tertiary teaching hospital in Adelaide between 2016 and 2020. Patients were grouped by 2\u2010year time periods before (group 1) and following (group 2) schedule change. Costs for the index presentation were multiplied for subsequent presentations. Costs and outcomes were compared for groups (standard statistics; <jats:italic>P<\/jats:italic> value &lt;\u20090.05 significant.)<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred forty patients (group 1, <jats:italic>n<\/jats:italic> =\u2009164; group 2, <jats:italic>n<\/jats:italic> =\u2009119) were identified, with the majority of these admitted due to nonsteroidal anti\u2010inflammatory drugs (NSAIDs) only. For CCCAs (NSAID\u2010containing), the same patients were admitted repeatedly with a reduction from 31 to eight admissions (<jats:italic>P<\/jats:italic> =\u20090.005), following rescheduling. The total cost of CCCA admissions was reduced from AU$ 561 691 for group 1 to AU$ 261 764 for group 2 (<jats:italic>P<\/jats:italic> &lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Australian rescheduling of CCCAs in 2018 resulted in a reduction in hospital admissions and costs related to GI complications. The cost savings, even in a single hospital department, were substantial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16080","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T11:44:16Z","timestamp":1680954256000},"page":"2240-2246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduced gastrointestinal\u2010related hospitalisation costs following rescheduling of over\u2010the\u2010counter codeine\u2010containing compound analgesics in Australia: results of a single hospital audit in South Australia"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8838-9721","authenticated-orcid":false,"given":"Ryan","family":"Mathias","sequence":"first","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bejamin","family":"Howes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Cock","sequence":"additional","affiliation":[{"name":"Drug and Alcohol Services South Australia (DASSA)  Adelaide South Australia Australia"},{"name":"College of Medicine and Public Health Flinders University of South Australia  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Cock","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Flinders Medical Centre  Adelaide South Australia Australia"},{"name":"College of Medicine and Public Health Flinders University of South Australia  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-015-1995-8"},{"volume-title":"Opioid Harm in Australia: And Comparisons Between Australia and Canada","year":"2018","author":"Australian Institute of Health and Welfare","key":"e_1_2_6_3_1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12595"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12809"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2010.tb03911.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2008.tb01509.x"},{"key":"e_1_2_6_8_1","first-page":"24","article-title":"Recognizing the risks of chronic nonsteroidal anti\u2010inflammatory drug use in older adults","volume":"18","author":"Marcum ZA","year":"2010","journal-title":"Ann Longterm Care"},{"key":"e_1_2_6_9_1","first-page":"29","article-title":"Over\u2010the\u2010counter codeine analgesic misuse and harm: characteristics of cases in Australia and New Zealand","volume":"124","author":"McAvoy BR","year":"2011","journal-title":"N Z Med J"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja12.11843"},{"key":"e_1_2_6_11_1","first-page":"59","article-title":"Misuse of over\u2010the\u2010counter codeine\u2010containing analgesics: dependence and other adverse effects","volume":"123","author":"Robinson GM","year":"2010","journal-title":"N Z Med J"},{"key":"e_1_2_6_12_1","unstructured":"Regulation Impact Statement: Codeine Re\u2010scheduling. 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