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Chronic opioid use before and after exercise therapy and patient education among patients with knee or hip osteoarthritis

Johansson, M. S. ; Pottegård, A. ; Søndergaard, J. ; Englund, M. LU orcid ; Grønne, D. T. ; Skou, S. T. ; Roos, E. M. LU and Thorlund, J. B. (2022) In Osteoarthritis and Cartilage 30(11). p.1536-1544
Abstract

Objective: To investigate changes in opioid use after supervised exercise therapy and patient education among knee or hip osteoarthritis patients with chronic opioid use. Method: In this cohort study, we linked data from the Good Life with osteoArthritis in Denmark register (GLA:D®; standardised treatment program for osteoarthritis; January 2013 to November 2018) with national health registries. Among 35,549 patients, 1,262 were classified as chronic opioid users based on amount and temporal distribution of dispensed opioids the year before the intervention. We investigated changes in opioid use, measured as mg oral morphine equivalents (OMEQs), from the year before the intervention to the year after using generalized estimating... (More)

Objective: To investigate changes in opioid use after supervised exercise therapy and patient education among knee or hip osteoarthritis patients with chronic opioid use. Method: In this cohort study, we linked data from the Good Life with osteoArthritis in Denmark register (GLA:D®; standardised treatment program for osteoarthritis; January 2013 to November 2018) with national health registries. Among 35,549 patients, 1,262 were classified as chronic opioid users based on amount and temporal distribution of dispensed opioids the year before the intervention. We investigated changes in opioid use, measured as mg oral morphine equivalents (OMEQs), from the year before the intervention to the year after using generalized estimating equations. Results: We found a 10% decrease in mg OMEQs from the year before to the year after the intervention (incidence rate ratio [IRR]: 0.90, 95% confidence interval [CI]: 0.86, 0.94). Additional analyses suggested this decrease to be mainly attributable to regulatory actions targeting opioid prescribing during the study period (IRR among patients participating in the intervention before: 0.98 [95% CI: 0.89, 1.07] vs after: 0.83 [0.74, 0.93] regulatory actions). In a random general population sample of matched chronic opioid users, a similar opioid use pattern was observed over time, further supporting the impact of regulatory actions on the opioid use in the study population. Conclusion: Among patients with knee or hip osteoarthritis and chronic opioid use, a standardised treatment program did not change opioid use when regulatory changes in opioid prescribing were taken into account.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic opioid use, Deprescribing, Exercise therapy, Osteoarthritis, Patient education
in
Osteoarthritis and Cartilage
volume
30
issue
11
pages
9 pages
publisher
Elsevier
external identifiers
  • pmid:35988705
  • scopus:85137060557
ISSN
1063-4584
DOI
10.1016/j.joca.2022.08.001
language
English
LU publication?
yes
id
6e061dc0-17a5-4a8e-b176-2731b26027b3
date added to LUP
2022-11-09 11:48:17
date last changed
2024-04-18 09:39:19
@article{6e061dc0-17a5-4a8e-b176-2731b26027b3,
  abstract     = {{<p>Objective: To investigate changes in opioid use after supervised exercise therapy and patient education among knee or hip osteoarthritis patients with chronic opioid use. Method: In this cohort study, we linked data from the Good Life with osteoArthritis in Denmark register (GLA:D®; standardised treatment program for osteoarthritis; January 2013 to November 2018) with national health registries. Among 35,549 patients, 1,262 were classified as chronic opioid users based on amount and temporal distribution of dispensed opioids the year before the intervention. We investigated changes in opioid use, measured as mg oral morphine equivalents (OMEQs), from the year before the intervention to the year after using generalized estimating equations. Results: We found a 10% decrease in mg OMEQs from the year before to the year after the intervention (incidence rate ratio [IRR]: 0.90, 95% confidence interval [CI]: 0.86, 0.94). Additional analyses suggested this decrease to be mainly attributable to regulatory actions targeting opioid prescribing during the study period (IRR among patients participating in the intervention before: 0.98 [95% CI: 0.89, 1.07] vs after: 0.83 [0.74, 0.93] regulatory actions). In a random general population sample of matched chronic opioid users, a similar opioid use pattern was observed over time, further supporting the impact of regulatory actions on the opioid use in the study population. Conclusion: Among patients with knee or hip osteoarthritis and chronic opioid use, a standardised treatment program did not change opioid use when regulatory changes in opioid prescribing were taken into account.</p>}},
  author       = {{Johansson, M. S. and Pottegård, A. and Søndergaard, J. and Englund, M. and Grønne, D. T. and Skou, S. T. and Roos, E. M. and Thorlund, J. B.}},
  issn         = {{1063-4584}},
  keywords     = {{Chronic opioid use; Deprescribing; Exercise therapy; Osteoarthritis; Patient education}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1536--1544}},
  publisher    = {{Elsevier}},
  series       = {{Osteoarthritis and Cartilage}},
  title        = {{Chronic opioid use before and after exercise therapy and patient education among patients with knee or hip osteoarthritis}},
  url          = {{http://dx.doi.org/10.1016/j.joca.2022.08.001}},
  doi          = {{10.1016/j.joca.2022.08.001}},
  volume       = {{30}},
  year         = {{2022}},
}