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/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% to 78.5%) received analgesics compared with control participants (37.5% to 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.
