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Opioid use among Danish patients with severe knee osteoarthritis: a drug utilization study

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Knee osteoarthritis (OA) is one of the most common musculoskeletal diseases. Opioids have been increasingly used in the treatment of severe knee OA-related pain, particularly in the USA. Less is known about the patterns of use of opioids among Danish patients with severe knee OA. We investigated opioid use among Danish patients with severe knee OA in the 5 years preceding knee replacement surgery (KR).

Methods

We identified adults who had undergone KR from January 1st, 2005, to December 31st, 2018, using the Danish National Patient Register. These patients were considered to have severe knee OA in the 5-year period leading up to KR. Individual-level data on prescribed opioids were retrieved from the Danish National Prescription Registry.

Results

We identified 77,168 severe knee OA patients (mean age 66 years). The prevalence of opioid users increased from 21% 5 years before KR to 40% 1 year before. Total use of opioids increased each year and doubled from 3254 mg oral morphine equivalents (OMEQ)/1000 individuals/day 5 years before to 6396 mg OMEQ/1000 individuals/day the year before KR corresponding to an increase of 3141 mg OMEQ (95% confidence interval 3010 to 3273). Tramadol was the most frequently used opioid. About 10% of the population accounted for 90% of the total opioid use.

Conclusion

Among patients with severe knee OA, the prevalence and total use of opioids doubled during the 5 years before KR. In addition, 10% of the study population was responsible for 90% of the opioids used.

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Authors and Affiliations

  1. Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark

    Matilde Lundberg, Melker Staffan Johansson, Jens Søndergaard & Jonas Bloch Thorlund

  2. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark

    Melker Staffan Johansson & Jonas Bloch Thorlund

Authors
  1. Matilde Lundberg
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  2. Melker Staffan Johansson
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  3. Jens Søndergaard
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  4. Jonas Bloch Thorlund
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Contributions

ML, JBT, and MSJ were involved in the design of the study. All authors provided input to the statistical analysis plan. ML performed the statistical analysis in collaboration with JBT and MSJ. ML wrote the first draft of the manuscript. All authors contributed to critically reviewing, editing, and revising the manuscript and approved the final version of the manuscript. JBT is the guarantor.

Corresponding author

Correspondence to Matilde Lundberg.

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Competing interests

JBT holds a research grant from Pfizer outside the submitted work. All other authors have no competing interests to declare.

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Lundberg, M., Johansson, M.S., Søndergaard, J. et al. Opioid use among Danish patients with severe knee osteoarthritis: a drug utilization study. Eur J Clin Pharmacol 78, 1481–1486 (2022). https://doi.org/10.1007/s00228-022-03350-x

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  • DOI: https://doi.org/10.1007/s00228-022-03350-x

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