Evidence map›Paper›PMID 37822018›Full record

Observational studyRheumatology (Oxford, England)2024

Analgesic prescribing in patients with inflammatory arthritis in England: observational studies in the Clinical Practice Research Datalink.

Ian C Scott, Rebecca Whittle, James Bailey, Helen Twohig, Samantha L Hider, Christian D Mallen, Sara Muller, Kelvin P Jordan

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Rheumatology (Oxford, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% 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

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

  1. Guideline
  2. Article
  3. Towards an individualised approach to pain management in inflammatory arthritis.Therapeutic advances in musculoskeletal disease · 2026
    Review
  4. UK Medical Cannabis Registry: An Updated Analysis of Inflammatory Arthritis.Clinical medicine insights. Arthritis and musculoskeletal disorders · 2026
    Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
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 2 institutions in 1 country.

Ian C ScottPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.ORCID 0000-0002-1268-9808
Rebecca WhittlePrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
James BaileyPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
Helen TwohigPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
Samantha L HiderPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.ORCID 0000-0002-9958-3909
Christian D MallenPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.ORCID 0000-0002-2677-1028
Sara MullerPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.ORCID 0000-0001-6645-5751
Kelvin P JordanPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.ORCID 0000-0003-4748-5335
Arthritis UK · GBMidlands Partnership NHS Foundation Trust · GB

Funding

Applied Research Collaboration West MidlandsDepartment of Health and Social CareNational Institute for Health and Care Research NIHR300826NIHRNIHR School for Primary Care Research
6 · The paper itself

Abstract

objectivesDespite little evidence that analgesics are effective in inflammatory arthritis (IA), studies report substantial opioid prescribing. The extent this applies to other analgesics is uncertain. We undertook a comprehensive evaluation of analgesic prescribing in patients with IA in the Clinical Practice Research Datalink Aurum to evaluate this.

methodsFrom 2004 to 2020, cross-sectional analyses evaluated analgesic prescription annual prevalence in RA, PsA and axial spondyloarthritis (axSpA), stratified by age, sex, ethnicity, deprivation and geography. Joinpoint regression evaluated temporal prescribing trends. Cohort studies determined prognostic factors at diagnosis for chronic analgesic prescriptions using Cox proportional hazards models.

resultsAnalgesic prescribing declined over time but remained common: 2004 and 2020 IA prescription prevalence was 84.2/100 person-years (PY) (95% CI 83.9, 84.5) and 64.5/100 PY (64.2, 64.8), respectively. In 2004, NSAIDs were most prescribed (56.1/100 PY; 55.8, 56.5), falling over time. Opioids were most prescribed in 2020 (39.0/100 PY; 38.7, 39.2). Gabapentinoid prescribing increased: 2004 prevalence 1.1/100 PY (1.0, 1.2); 2020 prevalence 9.9/100 PY (9.7, 10.0). Most opioid prescriptions were chronic (2020 prevalence 23.4/100 PY [23.2, 23.6]). Non-NSAID analgesic prescribing was commoner in RA, older people, females and deprived areas/northern England. Conversely, NSAID prescribing was commoner in axSpA/males, varying little by deprivation/geography. Peri-diagnosis was high-risk for starting chronic opioid/NSAID prescriptions. Prognostic factors for chronic opioid/gabapentinoid and NSAID prescriptions differed, with NSAIDs having no consistently significant association with deprivation (unlike opioids/gabapentinoids).

conclusionIA analgesic prescribing of all classes is widespread. This is neither evidence-based nor in line with guidelines. Peri-diagnosis is an opportune moment to reduce chronic analgesic prescribing.

Indexed as

AnalgesicsAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalPractice Patterns, Physicians'AdultAgedArthritis, RheumatoidCross-Sectional StudiesDrug PrescriptionsEnglandFemaleGabapentinHumansMaleMiddle AgedAnalgesicsAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalGabapentinanalgesicaxial spondyloarthritispainPsARA

Identifiers

PMID37822018
PMCPMC11147543
OpenAlexW4387563273

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.