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

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Abbott, AllanLinköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Ortopedkliniken i Linköping (författare)

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

Artikel/kapitelEngelska2022

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2021-10-22
Medical Journals Sweden AB,2022

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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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Språk:engelska

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Ämneskategori:art swepub-publicationtype

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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.

Ämnesord och genrebeteckningar

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

Biuppslag (personer, institutioner, konferenser, titlar ...)

Gustafsson, KristinLinköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Ryhov Cty Hosp, Sweden(Swepub:liu)krigu95 (författare)
Zhou, C.Ctr Registries Vastra Gotaland, Sweden (författare)
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 (författare)
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 (författare)
Linköpings universitetAvdelningen för prevention, rehabilitering och nära vård (creator_code:org_t)

Sammanhörande titlar

Ingår i:Acta Orthopaedica: Medical Journals Sweden AB93, s. 51-581745-36741745-3682

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Av författaren/redakt...: Abbott, Allan; Gustafsson, Kris ...; Zhou, C.; Rolfson, Ola, 19 ...; Limbäck Svensson ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Ortopedi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Allmänmedicin

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Av lärosätet: Göteborgs universitet; Linköpings universitet

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