Osteoarthritis (OA) is a common long-term condition that causes pain and disability. The risk of OA increases with age and females are more commonly affected. Pain is managed by a number of available medicines including paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. Recently, research has highlighted the involvement of multiple pain sensation pathways in OA and proposed the role of antidepressants and antiepileptic drugs for OA related pain. Patients with OA use different medicines for varying periods in their search for pain relief which consequently results in a wide variation in medicine use, however, information on medicine use and subsequent outcomes in patients with OA in the UK are limited. This study will explore the use of pain medicines and assess related outcomes, specifically falls and death, in patients with knee osteoarthritis (KOA) treated in GP practices in the UK. Information about patients, medicines and outcomes will be obtained from the CPRD, where prescription records will be retrieved to describe the medicines used, doses prescribed and durations, while clinical records will be retrieved to capture fall and death events. Findings from this study will inform clinical practitioners, policy makers and members of the public to collectively optimise safe use of medicines in KOA.
Osteoarthritis (OA) is a chronic condition that affects around 7 million people in the UK resulting in pain and disability that compromise quality of life and has substantial societal and economic burdens. Management focuses on pain relief using analgesics. Recently the role of antidepressants and antiepileptic drugs (AEDs) was suggested based on findings confirming the involvement of central and neuropathic mechanisms in OA related pain. In the UK, data on drug utilisation and the associated clinical outcomes in patients with OA are limited. We aim to describe drug utilisation patterns in patients with knee OA (KOA) and investigate the association of different drug utilisation patterns with relevant clinical outcomes such as risk of fall and all-cause mortality. Starting with descriptive analysis of the patient population, utilisation of the following classes: paracetamol, NSAIDs, opioids, antidepressants and AEDs, will be measured annually between 2000 and 2015 at a population level. Prescribed doses and durations will then be described on an individual patient level over the first year after prescribing. The incidence of falls and all-cause death will be determined and associations with cumulative exposure will be investigated with the use of time to event analysis using data from the CPRD, HES and ONS.
1. Prevalence and trends of analgesic prescribing in patients with KOA
2. Risk of falls in patients with KOA
3. Risk of all-cause mortality in patients with KOA
Roger Knaggs - Chief Investigator - University of Nottingham
Aqila Taqi - Corresponding Applicant - University of Nottingham
Harmony Otete - Collaborator - University Of Central Lancashire
Sonia Gran - Collaborator - University of Nottingham
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation