Lead Astray? The Hidden Contaminants in Australian Anabolic-Androgenic Steroid Market and Their Potential Health Impact.

Introduction: Unregulated anabolic-androgenic steroid (AAS) markets are a global phenomenon with significant variability in product composition and purity. This study aimed to determine the chemical composition of AAS sold in Australia.

Methods: This study analysed anonymously donated AAS samples.

Healthcare Practitioner and Other Professionals' Perspectives on Gabapentinoid Misuse and Dependence: A Systematic Review of Qualitative Studies.

Background And Objective: The global rise in gabapentinoid prescriptions for chronic pain has been striking. However, this trend has been accompanied by growing concerns about misuse and dependence. This qualitative systematic review aimed to synthesise the perspectives of healthcare practitioners and other professionals on these emerging challenges.

An evidence-based digital prescription opioid safety toolkit for national dissemination: co-design and user testing.

Introduction: Australia has one of the highest rates of opioid prescribing and prescription opioid-related harm in the world. Although effective for pain relief, the use of prescription opioids is a leading cause of preventable morbidity and mortality. Barriers exist for consumers identifying their own risk factors, accessing naloxone (opioid overdose antidote) and overdose prevention education.

Reviewing long-term opioid use in patients experiencing chronic pain in general practice: Activating patients and supporting clinical decision making.

Background: Australia has a high rate of opioid prescribing, which has been associated with multiple harms. Regular review of patients' opioid-related risk factors and realigning treatment improves clinical outcomes; however, general practitioners (GPs) can find this consultation difficult.

Objective: The aim of this article is to support GPs and their chronic pain patients who have been prescribed long-term opioids with a structured and validated opioid review process through the Routine Opioid Outcome Monitoring (ROOM) tool and the patient-led Opioid Safety Toolkit.

The Digital Library of Health Care Consultations and Simulated Health Care Student Teaching: Protocol for a Repository of Recordings to Support Communication Research.

Background: Miscommunication in health care is a major source of poor health outcomes, complaints about health care professionals, and poor patient satisfaction. Recordings from real-life consultations provide valuable data for communication research and education. Additionally, recordings from simulation-based education of health care students can provide valuable data for health care education research.

Prescription opioid supply-restricting policies and hospital use by people prescribed opioid medications, Victoria, 2018-22: a controlled interrupted time series analysis.

Objectives: To investigate the combined effect of two policies for reducing prescription opioid supply in Australia on hospital use by people prescribed opioids in primary care.

Study Design: Retrospective data linkage study; controlled interrupted time series analysis of linked primary care electronic medication records and hospital admissions data.

Setting: Three Victorian health care networks (Monash Health, Eastern Health, Peninsula Health); pre-intervention period: 1 April 2018 - 31 March 2020; intervention period: 1 April 2020 - 31 March 2022.

Use of Medicare-subsidised treatment services among people prescribed opioids for chronic non-cancer pain.

Objectives Australians receive healthcare services subsidised by the Medicare national health insurance scheme, including through the Chronic Disease Management Initiative supporting primary care management of chronic conditions. The use of such subsidised services by people with chronic non-cancer pain (CNCP) is unknown. This study examined Medicare-subsidised service use, including Chronic Disease Management items, allied health service use, and specialist attendances, among Australians prescribed opioids for CNCP.

Prevalence and risk factors for opioid overdose among women: A systematic review and meta-analysis.

Background: North America, Australia and parts of Europe have experienced recent increases in opioid overdoses. As most overdoses occur in men, less attention has focused on overdoses among women. To address this, we conducted a systematic review to examine the prevalence of opioid overdoses and to identify gender-specific risk factors.

A Scoping Review of the Emergence of Novel Synthetic Opioids in Australian Drug Markets: What Does This Mean for Harm Reduction Responses?

Issues: Rising synthetic opioid deaths in North America, and the emergence of nitazene harms has driven concern about novel synthetic opioids (NSO) in Australia. This scoping review aimed to map what is known about NSOs in Australia.

Approach: Scoping review of peer-reviewed and grey literature on NSO detections and harms.

Opioid dose trajectories and associations with opioid- and nonopioid-related emergency department presentations and hospital admissions.

Opioid deprescribing is a key strategy for reducing opioid-related adverse effects. However, although deprescribing can be associated with clinical benefits, international studies suggest that rapid dose reduction in those on long-term opioids may be associated with poorer outcomes. This study examines the association between different opioid dose trajectories and emergency department presentations or hospital admissions related to substance use and mental health in Victoria, Australia.

Understanding the first prescription: clinical and demographic drivers of strong opioid use in primary care.

Aim: To evaluate the demographic and clinical factors that influence the initiation of weak versus strong opioids among opioid-naïve patients in Australian primary care settings.

Methods: This retrospective cohort study focused on opioid-naïve patients, defined as those receiving an eligible opioid prescription with no prior opioid prescriptions in the prior year. The study used general practice data extracted in partnership with Primary Health Networks via the POpulation Level Analysis and Reporting (POLAR) platform.

A cross-sectional study of prescribing of antiseizure medication for the treatment of pain in Australia.

Background: Antiseizure medications, particularly gabapentinoids like pregabalin, are increasingly prescribed for pain management. Despite their growing use, evidence of their effectiveness for pain is mixed. This highlights the need for a clearer understanding of the prevalence and prescribing patterns of antiseizure medications in pain management.

Impacts of opioid stewardship in surgical settings: a scoping review.

Opioid stewardship programs have been implemented in many countries to reduce harms related to prescription opioid use. Yet, there is an evidence gap on the impact of these programs in surgical settings. This systematic scoping review aimed to examine the impact of opioid stewardship on opioid use and clinical outcomes, alongside assessing adherence, and barriers to its implementation in surgical settings.

Early High-Risk Opioid Prescribing and Persistent Opioid Use in Australian Workers with Workers' Compensation Claims for Back and Neck Musculoskeletal Disorders or Injuries: A Retrospective Cohort Study.

Background: Opioid prescribing to injured workers has increased despite evidence demonstrating that risks often outweigh the benefits. High-risk prescribing and persistent opioid use are often associated with harm. However, there are limited data on what predicts early high-risk and persistent opioid prescribing in Australian workers with back and neck-related injuries or disorders.

Longitudinal patterns of opioid dispensing dosages for compensated Australian workers with low back pain: a 3.5-year follow-up study.

Objective: To identify longitudinal patterns in opioid dispensing dosages for workers with low back pain within a workers' compensation setting and to explore the risk factors associated with high-dose and persistent opioid use.

Method: We included workers with accepted claims for low back pain received by insurers between January 1, 2010, and June 30, 2016, with a follow-up period of 3.5 years (data censoring on December 31, 2020) across Victoria.

National consensus statement on opioid agonist treatment in custodial settings.

Introduction: Opioid use and dependence are prevalent among incarcerated people, contributing to elevated rates of overdose and other harms in this population. Opioid agonist treatment (OAT) has been shown to be an effective intervention to mitigate these risks. However, challenges to health care implementation in the custodial sector result in suboptimal and variable access to OAT in prisons nationally.

Clinical and mental health characteristics among patients receiving medications for opioid use disorder treatment versus patients receiving low- and high-dose opioids when referred for pain management.

Objective: To examine the demographic and clinical characteristics of patients attending pain management services who were receiving opioid agonist treatment (ie, methadone or buprenorphine for the treatment of opioid use disorder) in comparison with those taking prescription opioid analgesics in oral morphine equivalent daily doses at low (<40 mg) and high doses (>100 mg) in a national database from the electronic Persistent Pain Outcomes Collaboration (ePPOC) in Australia.

Design: A cross-sectional study.

Setting: Australian pain services.

What influences Australian pharmacists' decisions to supply opioids? Results from a survey and randomised controlled factorial experiment.

Introduction: Prescription drug monitoring programs (PDMP) identify medication-related risks to support clinical decision-making. This study aims to report prescription medication refusal rates based on PDMP alerts and determine how PDMP alerts and other characteristics influence pharmacists' decisions to supply opioids.

Methods: Pharmacists completed an online survey and randomised controlled factorial experiment.

How Can We Make Information on Equity in Clinical Guidelines More Usable for Clinicians? A Case Study Methodology of General Practitioners.

Background: Clinical practice guidelines (CPGs) are moving toward greater consideration of population-level differences, like health inequities, when creating management recommendations. CPGs have the potential to reduce or perpetuate health inequities. The intrinsic design factors of electronic interfaces that contain CPGs are known barriers to guideline use.

Australian Community Pharmacists' Preparedness to Offer and Discuss Hepatitis C Testing and Treatment With Pharmacy Clients: A Representative Cross-Sectional Survey.

The World Health Organisation (WHO) has set goals to eliminate hepatitis C (HCV) as a global health threat by 2030. To meet this goal, Australia must increase testing and diagnosis, including expanding access to care through community pharmacists. This study aims to explore community pharmacists' preparedness to discuss and offer HCV testing and treatment.

Opioid prescribing prevalence and initiation rates in Victoria, Australia: insights from primary care data during a period of opioid policy changes (2017-2022).

Background: Opioid medications are widely prescribed for acute, chronic and cancer pain. In Australia, opioid prescribing rates remain high.

Aim: This study aimed to document patterns of primary care opioid prescribing from 2017 to 2022 by demographic characteristics in Victoria, Australia.

Australian community pharmacists' experiences of prescription drug monitoring programs: Comparisons between mandated and nonmandated states.

Background: Prescription drug monitoring programs (PDMPs) track patients' prescription records for high-risk medications and prompt real-time alerts to pharmacists when specific criteria are met. PDMPs are increasingly implemented by health care systems to attempt to mitigate harms associated with prescription opioids.

Objective: This study aims to explore and compare PDMP experiences among Australian community pharmacists from states where PDMP use is mandated and nonmandated.

A discrete choice experiment: Understanding patient preferences for managing chronic non-cancer pain.

Background: The management of chronic non-cancer pain (CNCP) is complex. Concerns about adverse effects associated with opioid pain medications and a lack of funding for holistic programs present challenges for decision-making among clinicians and patients. Discrete choice experiments (DCE) are one way of assessing and valuing patient treatment preferences.