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Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales / EMMA DAVIES

Swansea University Author: EMMA DAVIES

DOI (Published version): 10.23889/SUthesis.59404

Abstract

Background:Opioid prescribing in the UK has increased significantly since the start of the millennium and has been associated with a rise in chronic pain reporting. In Wales, despite concern about rising rates of opioid analgesic prescribing, no detailed examination of the data had been undertaken t...

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Published: Swansea 2021
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Sewell, Berni ; Jones, Mari ; Phillips, Ceri J. ; Rance, Jaynie
URI: https://cronfa.swan.ac.uk/Record/cronfa59404
first_indexed 2022-02-15T17:59:28Z
last_indexed 2022-02-16T04:27:13Z
id cronfa59404
recordtype RisThesis
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spelling 2022-02-15T18:30:19.3562279 v2 59404 2022-02-15 Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales b3d8367156dfdbae4481ce6c8dc7a648 EMMA DAVIES EMMA DAVIES true false 2022-02-15 Background:Opioid prescribing in the UK has increased significantly since the start of the millennium and has been associated with a rise in chronic pain reporting. In Wales, despite concern about rising rates of opioid analgesic prescribing, no detailed examination of the data had been undertaken to assess the changes in prescribing and its consequent impact on the population. Methods:In this study, anonymised, individual level data of people diagnosed with non-cancer pain in Wales was extracted from the Secure Anonymised Information Linkage (SAIL) Databank and used to scrutinise opioid analgesic prescribing trends in people aged 18 years and over, establish whether legislation or clinical guidance impacted on those trends and examine associations with increased healthcare use. The study was conducted in two phases. Phase 1 included a retrospective, repeated cross-sectional analysis of opioid analgesics issued from Primary Care, stratified by gender, age and socioeconomic status. Phase 2 of the study evaluated differences in healthcare service use and costs between individuals receiving opioids for defined non-cancer pain-related diagnoses and matched patients not receiving opioids. Results:Total opioid prescribing increased by 43.6% and strong opioids by 306.2% between 2005 and 2015. Women received 1.5 times more prescriptions than men. Increasing age was associated with higher prescribing rates. People in the most deprived areas received 2.4 times more prescriptions than in least deprived. People receiving opioid prescriptions accessed primary care four times more frequently than controls and had twice the number of hospital admissions. Opioid prescription was associated with 41% higher healthcare costs than noted in controls. Conclusion:This research highlights the need to develop a national strategy to address pain management and opioid stewardship in Wales. We must consider how to address the wide variability observed, particularly between areas of differing socioeconomic status. Further research should investigate what underlies continued opioid prescribing and how alternative strategies can be implemented in practice to reduce population harm and optimise the use of limited healthcare resources. E-Thesis Swansea Opioid analgesics, prescribing trends, non-cancer pain, resource utilisation, cost analysis, healthcare utilisation, socioeconomic deprivation, time series analysis 9 12 2021 2021-12-09 10.23889/SUthesis.59404 ORCiD identifier: https://orcid.org/0000-0003-1171-3201 COLLEGE NANME COLLEGE CODE Swansea University Sewell, Berni ; Jones, Mari ; Phillips, Ceri J. ; Rance, Jaynie Doctoral Ph.D Pharmacy Research UK (PRUK); Research grant number: PRUK-2016-PA1-A 2022-02-15T18:30:19.3562279 2022-02-15T17:55:48.9395631 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine EMMA DAVIES 1 59404__22383__1682a26695bf4e3981623a25dd42bbdd.pdf Davies_Emma_PhD_Thesis_Final_Redacted_Signature.pdf 2022-02-15T18:16:13.9046397 Output 27163276 application/pdf E-Thesis – open access true Copyright: The author, Emma Davies, 2021. true eng
title Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales
spellingShingle Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales
EMMA DAVIES
title_short Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales
title_full Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales
title_fullStr Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales
title_full_unstemmed Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales
title_sort Trends in Opioid Prescribing for Non-Cancer pain and Associated Resource Utilisation in Wales
author_id_str_mv b3d8367156dfdbae4481ce6c8dc7a648
author_id_fullname_str_mv b3d8367156dfdbae4481ce6c8dc7a648_***_EMMA DAVIES
author EMMA DAVIES
author2 EMMA DAVIES
format E-Thesis
publishDate 2021
institution Swansea University
doi_str_mv 10.23889/SUthesis.59404
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Background:Opioid prescribing in the UK has increased significantly since the start of the millennium and has been associated with a rise in chronic pain reporting. In Wales, despite concern about rising rates of opioid analgesic prescribing, no detailed examination of the data had been undertaken to assess the changes in prescribing and its consequent impact on the population. Methods:In this study, anonymised, individual level data of people diagnosed with non-cancer pain in Wales was extracted from the Secure Anonymised Information Linkage (SAIL) Databank and used to scrutinise opioid analgesic prescribing trends in people aged 18 years and over, establish whether legislation or clinical guidance impacted on those trends and examine associations with increased healthcare use. The study was conducted in two phases. Phase 1 included a retrospective, repeated cross-sectional analysis of opioid analgesics issued from Primary Care, stratified by gender, age and socioeconomic status. Phase 2 of the study evaluated differences in healthcare service use and costs between individuals receiving opioids for defined non-cancer pain-related diagnoses and matched patients not receiving opioids. Results:Total opioid prescribing increased by 43.6% and strong opioids by 306.2% between 2005 and 2015. Women received 1.5 times more prescriptions than men. Increasing age was associated with higher prescribing rates. People in the most deprived areas received 2.4 times more prescriptions than in least deprived. People receiving opioid prescriptions accessed primary care four times more frequently than controls and had twice the number of hospital admissions. Opioid prescription was associated with 41% higher healthcare costs than noted in controls. Conclusion:This research highlights the need to develop a national strategy to address pain management and opioid stewardship in Wales. We must consider how to address the wide variability observed, particularly between areas of differing socioeconomic status. Further research should investigate what underlies continued opioid prescribing and how alternative strategies can be implemented in practice to reduce population harm and optimise the use of limited healthcare resources.
published_date 2021-12-09T20:09:47Z
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