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- Abbott, AllanLinköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Ortopedkliniken i Linköping (author)
Analgesic prescriptions received by patients before commencing the BOA model of care for osteoarthritis: a Swedish national registry study with matched reference and clinical guideline benchmarking
- Article/chapterEnglish2022
Publisher, publication year, extent ...
- 2021-10-22
- Medical Journals Sweden AB,2022
Numbers
- LIBRIS-ID:oai:gup.ub.gu.se/309216
- https://gup.ub.gu.se/publication/309216URI
- https://doi.org/10.1080/17453674.2021.1992932DOI
- https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-180746URI
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- Language:English
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- Background and purpose - Swedish clinical guidelines for osteoarthritis (OA) prioritize patient education, exercise, and-if necessary-weight reduction before considering adjunct pharmacological intervention. Contrariwise, we investigated the proportion and type of dispensed analgesic prescriptions in Sweden received by patients during 3 years before commencing non-pharmacological primary care interventions for OA (2008-2016) compared with the general population. Furthermore, we analyzed the proportion of analgesic prescriptions dispensed before (2008-2012) compared with after (2012-2016) guideline publication in terms of concordance with clinical guideline recommendations. Patients and methods - Patients with hip or knee OA (n = 72,069) from the Better Management of OA national quality register receiving non-pharmacological interventions in primary care between 2008 and 2016 were included (OA cohort). An age, sex, and residence matched reference cohort (n = 216,207) was formed from the Swedish Total Population Register. Based on a period 3 years prior to inclusion in the OA cohort, Swedish Prescribed Drug Register data was linked to both the OA and reference cohorts. Results - Compared with the reference cohort, a distinctly larger proportion of the OA cohort had dispensed prescriptions for most types of analgesics, increasing exponentially each year prior to commencing non-pharmacological intervention. Since guideline publication, the proportion of the OA cohort having no dispensed prescription analgesics prior to non-pharmacological primary care intervention concordantly increased by 5.0% (95% CI 4.2-5.9). Furthermore, dispensed prescriptions concordantly decreased for non-selective NSAIDs -8.6% (CI -9.6 to -7.6), weak opioids -6.8% (CI -7.7 to -5.9), glucosamine -9.5% (CI -9.8 to -8.8). and hyaluronic acid -1.6% (CI -1.8 to -1.5) but discordantly increased for strong opioids 2.8% (CI 2.1-3.4) and glucocorticoid intra-articular injection for hip OA 2.1% (CI 1.0-3.1). Interpretation - In Sweden, dispensed prescription of analgesics commonly occurred before initiating non-pharmacological primary care interventions for OA but reduced modestly after guideline publication, which prioritizes non-pharmacological before pharmacological interventions. Additional modest improvements occurred in the stepped-care prioritization of analgesic prescription types. However, future strategies are required to curb an increase of strong opioids prescription for OA and glucocorticoid intra-articular injection for hip OA.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
- hip osteoarthritis
- safety
- knee
- pain
- classification
- metaanalysis
- population
- management
- efficacy
- criteria
- Orthopedics
Added entries (persons, corporate bodies, meetings, titles ...)
- Gustafsson, KristinLinköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Ryhov Cty Hosp, Sweden(Swepub:liu)krigu95 (author)
- Zhou, C.Ctr Registries Vastra Gotaland, Sweden (author)
- Rolfson, Ola,1973Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Univ Gothenburg, Sweden(Swepub:gu)xrolol (author)
- Limbäck Svensson, GunillaGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Univ Gothenburg, Sweden; Ctr Registries, Sweden(Swepub:gu)xlimgu (author)
- Linköpings universitetAvdelningen för prevention, rehabilitering och nära vård (creator_code:org_t)
Related titles
- In:Acta Orthopaedica: Medical Journals Sweden AB93, s. 51-581745-36741745-3682
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