Analgesic Prescribing Trends for Inflammatory Arthritis in England

Pavankumar Kamat

Disclosures

December 23, 2021

Takeaway

  • The annual prevalence of overall analgesic prescriptions in England fell slightly over a 15-year period (2000-2015).

  • Analgesics, particularly long-term opioids continue to be commonly prescribed to patients with inflammatory arthritis (IA).

Why this matters

  • Findings highlight the urgent need for interventions to deliver safer analgesic prescribing in patients with IA.

  • Understanding the factors driving clinician analgesic prescribing and patient analgesic use in IA is the first step towards developing interventions.

Study design

  • Repeated cross-sectional analyses evaluated the annual prevalence of analgesic prescriptions in IA cases (rheumatoid arthritis [RA]/psoriatic arthritis [PsA]/axial spondyloarthritis [SpA]) and matched control participants without IA, identified from the Consultations in Primary Care Archive (2000-2015).

  • Analgesic prescriptions were classified into basic, opioids, gabapentinoids, and oral nonsteroidal anti-inflammatory drugs (NSAIDs) and sub-classified into chronic (≥3 prescriptions/calendar year) and intermittent (1-2 prescriptions/calendar year).

  • Funding: National Institute of Health Research.

Key results

  • Across all years, a higher proportion of IA cases (65.3%-78.5%) received analgesics compared with control participants (37.5%-41.1%).

  • Opioid prescribing decreased in IA cases between 2000 and 2015, yet 45.4% and 32.9% of IA cases received ≥1 and ≥3 opioid prescriptions, respectively, in 2015.

  • The prevalence of gabapentinoid prescriptions increased from 2.0%  in 2007 to 9.5%in 2015 in IA cases and from 1.2% in 2007 to 4.7% in 2015 in control participants.

  • The prevalence of oral NSAID prescriptions decreased from 53.7% in 2000 to 25.0% in 2015 in IA cases and from 11.9% in 2000 to 6.8% in 2015 in control participants.

  • Across all years, analgesic prescribing was more common in RA cases than in PsA/axial SpA cases.

Limitations

  • Study evaluated prescribing data from a single English region.

Scott IC, Bailey J, White C, Mallen CD, Muller S. Analgesia Prescribing in Patients with Inflammatory Arthritis in England: An Observational Study Using Electronic Healthcare Record Data. Rheumatology (Oxford). 2021 Nov 24 [Epub ahead of print]. doi: 10.1093/rheumatology/keab870. PMID: 34849617 View abstract.

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