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The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK

Jun Han, Martin Rolles, Fatemeh Torabi Orcid Logo, Rowena Griffiths, Stuart Bedston, Ashley Akbari Orcid Logo, Bruce Burnett, Jane Lyons, Giles Greene, Rebecca Thomas, Tamsin Long, Cathy Arnold, Dyfed Wyn Huws, Mark Lawler, Ronan Lyons Orcid Logo

Supportive Care in Cancer, Volume: 31, Issue: 9

Swansea University Authors: Jun Han, Martin Rolles, Fatemeh Torabi Orcid Logo, Rowena Griffiths, Stuart Bedston, Ashley Akbari Orcid Logo, Bruce Burnett, Jane Lyons, Ronan Lyons Orcid Logo

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DOI (Published version): 10.1007/s00520-023-07944-8

Abstract

Purpose Public health measures instituted at the onset of the COVID-19 pandemic in the UK in 2020 had profound effects on the cancer patient pathway. We hypothesise that this may have affected analgesic prescriptions for cancer patients in primary care. Methods: A whole-nation retrospective, observa...

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Published in: Supportive Care in Cancer
ISSN: 0941-4355 1433-7339
Published: Springer Science and Business Media LLC 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa64135
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We hypothesise that this may have affected analgesic prescriptions for cancer patients in primary care. Methods: A whole-nation retrospective, observational study of opioid and antineuropathic analgesics prescribed in primarycare for two cohorts of cancer patients in Wales, using linked anonymised data to evaluate the impact of the pandemic and variation between different demographic backgrounds. Results: We found a significant increase in strong opioid prescriptions during the pandemic for patients within their first 12 months of diagnosis with a common cancer (incidence rate ratio (IRR) 1.15, 95% CI: 1.12&#x2013;1.18, p &lt; 0.001 for strong opioids) and significant increases in strong opioid and antineuropathic prescriptions for patients in the last 3 months prior to a cancer-related death (IRR = 1.06, 95% CI: 1.04&#x2013;1.07, p &lt; 0.001 for strong opioids; IRR = 1.11, 95% CI: 1.08&#x2013;1.14, p &lt; 0.001 for antineuropathics). A spike in opioid prescriptions for patients diagnosed in Q2 2020 and those who died in Q2 2020 was observed and interpreted as stockpiling. More analgesics were prescribed in more deprived quintiles. This diferential was less pronounced in patients towards the end of life, which we attribute to closer professional supervision. Conclusions: We demonstrate significant changes to community analgesic prescriptions for cancer patients related to the UK pandemic and illustrate prescription patterns linked to patients&#x2019; demographic background.</abstract><type>Journal Article</type><journal>Supportive Care in Cancer</journal><volume>31</volume><journalNumber>9</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0941-4355</issnPrint><issnElectronic>1433-7339</issnElectronic><keywords>COVID-19 pandemic &#xB7; Cancer &#xB7; Pain &#xB7; Prescription &#xB7; Primary care &#xB7; Analgesia</keywords><publishedDay>1</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-09-01</publishedDate><doi>10.1007/s00520-023-07944-8</doi><url>http://dx.doi.org/10.1007/s00520-023-07944-8</url><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1), Health Data Research UK (grant number: HDR-9006) and ADR UK (grant ES/S007393/1). This work was also supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales, and DATA-CAN, the UK Health Data Research Hub for Cancer. Acknowledgements: This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. The collaboration was led by the Swansea University Health Data Research UK team under the direction of the Welsh Government Technical Advisory Cell (TAC) and includes the following groups and organisations: the SAIL Databank, Administrative Data Research (ADR) Wales, Digital Health and Care Wales (DHCW), Public Health Wales, NHS Shared Services Partnership (NWSSP) and the Welsh Ambulance Service Trust (WAST).</funders><projectreference/><lastEdited>2023-09-29T16:51:04.1347603</lastEdited><Created>2023-08-24T20:56:57.9418281</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Jun</firstname><surname>Han</surname><order>1</order></author><author><firstname>Martin</firstname><surname>Rolles</surname><order>2</order></author><author><firstname>Fatemeh</firstname><surname>Torabi</surname><orcid>0000-0002-5853-4625</orcid><order>3</order></author><author><firstname>Rowena</firstname><surname>Griffiths</surname><order>4</order></author><author><firstname>Stuart</firstname><surname>Bedston</surname><order>5</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>6</order></author><author><firstname>Bruce</firstname><surname>Burnett</surname><order>7</order></author><author><firstname>Jane</firstname><surname>Lyons</surname><orcid/><order>8</order></author><author><firstname>Giles</firstname><surname>Greene</surname><order>9</order></author><author><firstname>Rebecca</firstname><surname>Thomas</surname><order>10</order></author><author><firstname>Tamsin</firstname><surname>Long</surname><order>11</order></author><author><firstname>Cathy</firstname><surname>Arnold</surname><order>12</order></author><author><firstname>Dyfed Wyn</firstname><surname>Huws</surname><order>13</order></author><author><firstname>Mark</firstname><surname>Lawler</surname><order>14</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>15</order></author></authors><documents><document><filename>64135__28668__c1cb76911bc3406cb5558ceeb2bc6114.pdf</filename><originalFilename>64135.VOR.pdf</originalFilename><uploaded>2023-09-29T16:48:42.6314088</uploaded><type>Output</type><contentLength>2830012</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2023-09-29T16:51:04.1347603 v2 64135 2023-08-24 The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK 4594ac13d8f8030ac682224965f87f2b Jun Han Jun Han true false cc2f11f27a853d25285959be925b5016 Martin Rolles Martin Rolles true false f569591e1bfb0e405b8091f99fec45d3 0000-0002-5853-4625 Fatemeh Torabi Fatemeh Torabi true false 381464f639f98bd388c29326ca7f862c Rowena Griffiths Rowena Griffiths true false c79d07eaba5c9515c0df82b372b76a41 Stuart Bedston Stuart Bedston true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 8d87ac7e0a56b9e3aac59319ed848078 Bruce Burnett Bruce Burnett true false 1b74fa5125a88451c52c45bcf20e0b47 Jane Lyons Jane Lyons true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2023-08-24 MEDS Purpose Public health measures instituted at the onset of the COVID-19 pandemic in the UK in 2020 had profound effects on the cancer patient pathway. We hypothesise that this may have affected analgesic prescriptions for cancer patients in primary care. Methods: A whole-nation retrospective, observational study of opioid and antineuropathic analgesics prescribed in primarycare for two cohorts of cancer patients in Wales, using linked anonymised data to evaluate the impact of the pandemic and variation between different demographic backgrounds. Results: We found a significant increase in strong opioid prescriptions during the pandemic for patients within their first 12 months of diagnosis with a common cancer (incidence rate ratio (IRR) 1.15, 95% CI: 1.12–1.18, p < 0.001 for strong opioids) and significant increases in strong opioid and antineuropathic prescriptions for patients in the last 3 months prior to a cancer-related death (IRR = 1.06, 95% CI: 1.04–1.07, p < 0.001 for strong opioids; IRR = 1.11, 95% CI: 1.08–1.14, p < 0.001 for antineuropathics). A spike in opioid prescriptions for patients diagnosed in Q2 2020 and those who died in Q2 2020 was observed and interpreted as stockpiling. More analgesics were prescribed in more deprived quintiles. This diferential was less pronounced in patients towards the end of life, which we attribute to closer professional supervision. Conclusions: We demonstrate significant changes to community analgesic prescriptions for cancer patients related to the UK pandemic and illustrate prescription patterns linked to patients’ demographic background. Journal Article Supportive Care in Cancer 31 9 Springer Science and Business Media LLC 0941-4355 1433-7339 COVID-19 pandemic · Cancer · Pain · Prescription · Primary care · Analgesia 1 9 2023 2023-09-01 10.1007/s00520-023-07944-8 http://dx.doi.org/10.1007/s00520-023-07944-8 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University SU Library paid the OA fee (TA Institutional Deal) This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1), Health Data Research UK (grant number: HDR-9006) and ADR UK (grant ES/S007393/1). This work was also supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales, and DATA-CAN, the UK Health Data Research Hub for Cancer. Acknowledgements: This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. The collaboration was led by the Swansea University Health Data Research UK team under the direction of the Welsh Government Technical Advisory Cell (TAC) and includes the following groups and organisations: the SAIL Databank, Administrative Data Research (ADR) Wales, Digital Health and Care Wales (DHCW), Public Health Wales, NHS Shared Services Partnership (NWSSP) and the Welsh Ambulance Service Trust (WAST). 2023-09-29T16:51:04.1347603 2023-08-24T20:56:57.9418281 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Jun Han 1 Martin Rolles 2 Fatemeh Torabi 0000-0002-5853-4625 3 Rowena Griffiths 4 Stuart Bedston 5 Ashley Akbari 0000-0003-0814-0801 6 Bruce Burnett 7 Jane Lyons 8 Giles Greene 9 Rebecca Thomas 10 Tamsin Long 11 Cathy Arnold 12 Dyfed Wyn Huws 13 Mark Lawler 14 Ronan Lyons 0000-0001-5225-000X 15 64135__28668__c1cb76911bc3406cb5558ceeb2bc6114.pdf 64135.VOR.pdf 2023-09-29T16:48:42.6314088 Output 2830012 application/pdf Version of Record true This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made true eng http://creativecommons.org/licenses/by/4.0/
title The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK
spellingShingle The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK
Jun Han
Martin Rolles
Fatemeh Torabi
Rowena Griffiths
Stuart Bedston
Ashley Akbari
Bruce Burnett
Jane Lyons
Ronan Lyons
title_short The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK
title_full The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK
title_fullStr The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK
title_full_unstemmed The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK
title_sort The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK
author_id_str_mv 4594ac13d8f8030ac682224965f87f2b
cc2f11f27a853d25285959be925b5016
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381464f639f98bd388c29326ca7f862c
c79d07eaba5c9515c0df82b372b76a41
aa1b025ec0243f708bb5eb0a93d6fb52
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author_id_fullname_str_mv 4594ac13d8f8030ac682224965f87f2b_***_Jun Han
cc2f11f27a853d25285959be925b5016_***_Martin Rolles
f569591e1bfb0e405b8091f99fec45d3_***_Fatemeh Torabi
381464f639f98bd388c29326ca7f862c_***_Rowena Griffiths
c79d07eaba5c9515c0df82b372b76a41_***_Stuart Bedston
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
8d87ac7e0a56b9e3aac59319ed848078_***_Bruce Burnett
1b74fa5125a88451c52c45bcf20e0b47_***_Jane Lyons
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Jun Han
Martin Rolles
Fatemeh Torabi
Rowena Griffiths
Stuart Bedston
Ashley Akbari
Bruce Burnett
Jane Lyons
Ronan Lyons
author2 Jun Han
Martin Rolles
Fatemeh Torabi
Rowena Griffiths
Stuart Bedston
Ashley Akbari
Bruce Burnett
Jane Lyons
Giles Greene
Rebecca Thomas
Tamsin Long
Cathy Arnold
Dyfed Wyn Huws
Mark Lawler
Ronan Lyons
format Journal article
container_title Supportive Care in Cancer
container_volume 31
container_issue 9
publishDate 2023
institution Swansea University
issn 0941-4355
1433-7339
doi_str_mv 10.1007/s00520-023-07944-8
publisher Springer Science and Business Media LLC
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
url http://dx.doi.org/10.1007/s00520-023-07944-8
document_store_str 1
active_str 0
description Purpose Public health measures instituted at the onset of the COVID-19 pandemic in the UK in 2020 had profound effects on the cancer patient pathway. We hypothesise that this may have affected analgesic prescriptions for cancer patients in primary care. Methods: A whole-nation retrospective, observational study of opioid and antineuropathic analgesics prescribed in primarycare for two cohorts of cancer patients in Wales, using linked anonymised data to evaluate the impact of the pandemic and variation between different demographic backgrounds. Results: We found a significant increase in strong opioid prescriptions during the pandemic for patients within their first 12 months of diagnosis with a common cancer (incidence rate ratio (IRR) 1.15, 95% CI: 1.12–1.18, p < 0.001 for strong opioids) and significant increases in strong opioid and antineuropathic prescriptions for patients in the last 3 months prior to a cancer-related death (IRR = 1.06, 95% CI: 1.04–1.07, p < 0.001 for strong opioids; IRR = 1.11, 95% CI: 1.08–1.14, p < 0.001 for antineuropathics). A spike in opioid prescriptions for patients diagnosed in Q2 2020 and those who died in Q2 2020 was observed and interpreted as stockpiling. More analgesics were prescribed in more deprived quintiles. This diferential was less pronounced in patients towards the end of life, which we attribute to closer professional supervision. Conclusions: We demonstrate significant changes to community analgesic prescriptions for cancer patients related to the UK pandemic and illustrate prescription patterns linked to patients’ demographic background.
published_date 2023-09-01T20:24:07Z
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