Evidence map›Paper›PMID 35672693›Full record

ArticleBMC musculoskeletal disorders2022

Primary care consultations and pain medicine prescriptions: a comparison between patients with and without chronic pain after total knee replacement.

Rafael Pinedo-Villanueva, Spyros Kolovos, Christopher Maronga, Antonella Delmestri, Nick Howells, Andrew Judge, Rachael Gooberman-Hill, Vikki Wylde

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Rafael Pinedo-VillanuevaNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, OX3 7LD, Oxford, UK. rafael.pinedo@ndorms.ox.ac.uk.
Spyros KolovosNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, OX3 7LD, Oxford, UK.
Christopher MarongaNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, OX3 7LD, Oxford, UK.
Antonella DelmestriNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, OX3 7LD, Oxford, UK.
Nick HowellsOrthopaedic Department, North Bristol NHS Trust, Bristol, UK.
Andrew JudgeNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, OX3 7LD, Oxford, UK.
Rachael Gooberman-HillMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK.
Vikki WyldeMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK.
Nuffield Orthopaedic Centre · GBUniversity Hospitals Bristol NHS Foundation Trust · GBNorth Bristol NHS Trust · GBUniversity of Bristol · GB

Funding

National Institute for Health Research RP-PG-0613-20001
6 · The paper itself

Abstract

backgroundApproximately 20% of patients experience chronic pain after total knee replacement (TKR). The impact of chronic pain after TKR on primary care services in the UK is currently unknown. The aim of this study was to compare primary care consultations and pain medicine prescriptions between patients with and without chronic pain after TKR.

methodsData from 5,055 patients who received TKR between 2009 and 2016 with anonymised linked data from the Clinical Practice Research Datalink Gold (CPRD) and English Hospital Episode Statistics (HES) Patient Reported Outcome Measures (PROMs) programme were analysed. The exposure time was from 10 years pre-operative to eight years post-operative. Patients with a score ≤ 14 on the Oxford Knee Score pain component scale at 6 months post-operative were classified as having chronic pain after TKR. Primary care consultations and prescribed pain medicines were quantified, and costs calculated based on national cost data.

results721 patients (14%) had chronic pain after TKR. The prevalence and costs of primary care consultations and pain medicine prescriptions per year were consistently higher for patients with chronic pain after TKR compared with those without chronic pain after TKR; these differences were observed both before and after surgery. There was a substantial and sustained increase in the cost of opioid prescriptions after surgery for patients with chronic pain after TKR, peaking at seven years post-operative.

conclusionsIncreased primary care consultations and pain medicine prescriptions associated with chronic pain after TKR represent a considerable financial cost to primary care services. Evaluation of interventions to reduce the risk of developing this pain condition and improve the early management of pain after TKR are needed to improve outcomes for patients and reduce costs to healthcare services.

Indexed as

Arthroplasty, Replacement, KneeChronic PainOsteoarthritis, KneeHumansPrescriptionsPrimary Health CareReferral and ConsultationChronic painEnglandOpioidPrimary careTotal knee replacement

Identifiers

PMID35672693
PMCPMC9172077
OpenAlexW4281674568

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.