title: Do transdermal opioids affect the personal socioeconomic costs of healthcare access in an australian rural pain population? A comparison with oral opioids.
abstract: OBJECTIVE
  To determine whether there are differences in the personal socioeconomic costs of healthcare access between transdermal (TD) and oral opioid use in a rural population with chronic noncancer pain (CNCP).
  
  
  METHODS
  An observational longitudinal study, measuring change in the self-reported personal time and expense of healthcare access by route of opioid administration over time (monthly for 1 year). Subjects were opioid treated patients with CNCP from North West Tasmania, Australia. Subjects completed monthly datasheets by recording all personal healthcare access time and expense, together with the route(s) of opioid administration. The outcome measures of mean monthly healthcare time (MHT) and expense (MHE), by route of opioid administration, were analyzed using generalized estimating equations with robust standard errors.
  
  
  RESULTS
  The details of 10,564 healthcare contacts from 198 subjects were obtained during the study. Total mean MHT with oral opioids was 3.76 hours (95% confidence interval [CI] = 2.21-5.32) and unchanged (p = 0.59) with TD opioids at 3.48 hours (95% CI = 2.23-4.72). Total mean MHE with oral opioids was AU$ 92.72 (95% CI = 51.21-134.24) and unchanged (p = 0.81) with TD opioids atAU$ 89.12 (95% CI = 54.53-123.71).
  
  
  CONCLUSIONS
  The personal socioeconomic costs of healthcare access for rural patients with CNCP are similar for TD and oral opioid use. The prolonged analgesic affect of TD opioids may be advantageous for rural population.
authors.affiliation: University of Tasmania, Burnie, Tasmania, Australia.
authors.forename: John S
authors.initials: JS
authors.lastname: Henshaw
authors.forename: Judi
authors.initials: J
authors.lastname: Walker
authors.forename: Dom
authors.initials: D
authors.lastname: Geraghty
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000191:economics*; D001315:Australia; D059350:Chronic Pain / Q000188:drug therapy* / Q000191:economics*; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012424:Rural Population; D057566:Self Report; D012959:Socioeconomic Factors
chemical_list: D000701:Analgesics, Opioid