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

Yu, Dahai

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



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 2015-2019 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 to 2.7) between 10-1 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.

Journal Article Type Article
Acceptance Date Feb 16, 2022
Online Publication Date Mar 17, 2022
Publication Date 2022-06
Publicly Available Date May 30, 2023
Journal Osteoarthritis and Cartilage
Print ISSN 1063-4584
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 30
Issue 6
Pages 815-822
Keywords Total knee replacement; Opioid; Electronic health care record
Publisher URL


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