Opioid use prior to total knee replacement: comparative analysis of trends in England and Sweden

YU, D., HELLBERG, C., APPLEYARD, T., DELL'ISOLA, A., THOMAS, G.E.R., TURKIEWICZ, A., ENGLUND, M. and PEAT, George (2022). Opioid use prior to total knee replacement: comparative analysis of trends in England and Sweden. Osteoarthritis and Cartilage, 30 (6), 815-822.

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Official URL: https://www.sciencedirect.com/science/article/pii/...
Open Access URL: https://www.sciencedirect.com/science/article/pii/... (Published version)
Link to published version:: https://doi.org/10.1016/j.joca.2022.02.621
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    Abstract

    Objectives: To describe and compare trends in the frequency of opioid prescribing/dispensing in English and Swedish patients with osteoarthritis prior to total knee replacement (TKR). Methods: 49,043 patients from an English national database (Clinical Practice Research Datalink) and 5,955 patients from the Swedish Skåne Healthcare register undergoing TKR between 2015 and 2019 were included, alongside 1:1 age-, sex-, and practice (residential area) matched controls. Annual prevalence and prevalence rates ratio (PRR) of opioid prescribing/dispensing (any, by strength) in the 10 years prior to TKR (or matched index date for controls) were estimated using Poisson regression. Results: In England and Sweden, the prevalence of patients with osteoarthritis receiving any opioid prior to TKR increased towards the date of surgery from 24% to 44% in England and from 16% to 33% in Sweden. Prescribing in controls was stable, resulting in an increasing PRR (1.6–2.7) between 10 and 1 years prior to index date in both countries. No relevant cohort or period effect was observed in either country. Prevalence of opioid prescribing was higher in English cases and controls; weaker opioids were more commonly prescribed in England, stronger opioids in Sweden. Conclusions: Temporal prevalence patterns of opioid prescribing between cases and controls are similar in England and Sweden. Opioids are still commonly used in TKR cases in both countries highlighting the lack of valid alternatives for OA pain management.

    Item Type: Article
    Uncontrolled Keywords: Total knee replacement; Opioid; Electronic health care record; Electronic health care record; Opioid; Total knee replacement; Analgesics, Opioid; Arthroplasty, Replacement, Knee; England; Humans; Osteoarthritis; Practice Patterns, Physicians'; Sweden; Humans; Osteoarthritis; Analgesics, Opioid; Arthroplasty, Replacement, Knee; England; Sweden; Practice Patterns, Physicians'; Arthritis & Rheumatology; 0903 Biomedical Engineering; 1103 Clinical Sciences; 1106 Human Movement and Sports Sciences
    Identification Number: https://doi.org/10.1016/j.joca.2022.02.621
    Page Range: 815-822
    SWORD Depositor: Symplectic Elements
    Depositing User: Symplectic Elements
    Date Deposited: 01 Aug 2022 11:19
    Last Modified: 01 Aug 2022 11:19
    URI: http://shura.shu.ac.uk/id/eprint/30530

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