Trends for opioid prescribing and the impact of the COVID-19 pandemic in patients with rheumatic and musculoskeletal diseases between 2006 and 2021
Authors' conclusion
The plateauing or decreasing trend of opioid users for RMDs after 2018 may reflect the efforts to tackle rising opioid prescribing in the UK. The pandemic led to fewer people on opioids for most RMDs, providing reassurance that there was no sudden increase in opioid prescribing during the pandemic.
Study context
- Population
- Adults with RA, PsA, axial spondyloarthritis (AxSpA), SLE, OA and FM with opioid prescriptions, 1 January 2006–31 August 2021, without cancer, UK primary care
- Participants
- 1,313,519 RMD patients
- Exposure
- Opioid prescribing trends 2006–2021 and pre-pandemic vs pandemic trend
- Outcome
- Age- and gender-standardized yearly rates of new and prevalent opioid users; mean MME/day in prevalent users
- Follow-up
- 2006–2021
Methodological detailsage- and gender-standardized yearly rates, regression models (interrupted time series) for pandemic impact
- Age- and gender-standardized yearly rates
- Regression models (interrupted time series) for pandemic impact
Main finding
As reported in the abstract
New opioid users per 10 000 persons · 2006 → 2018 or 2019 → 2021
| Group | Value | 2018 or 2019 | 2021 |
|---|---|---|---|
| RA | 2.6 /10 000 persons | 4.5 | 2.4 |
| PsA | 1.0 /10 000 persons | 1.8 | 1.2 |
| FM | 3.4 /10 000 persons | 8.7 | 5.9 |
Value
RA2.6 /10 000 persons
PsA1.0 /10 000 persons
FM3.4 /10 000 persons
2018 or 2019
RA4.5
PsA1.8
FM8.7
2021
RA2.4
PsA1.2
FM5.9
- Increase in prevalent opioid users in FM between 2006 and 2021
- 4.5-fold
- Morphine milligram equivalents (MME)/day increased for all rheumatic and musculoskeletal diseases (RMDs), highest for FM
- ≥35
Observational data: associations, not effects.
Further findings
Trend in prevalent opioid users during COVID-19 lockdowns (Jan 2015–Aug 2021)
- RA, PsA and FM showed significant changes in the trend of prevalent opioid users
- FM trend increased pre-pandemic and started decreasing during the pandemic
Original publication
Trends for opioid prescribing and the impact of the COVID-19 pandemic in patients with rheumatic and musculoskeletal diseases between 2006 and 2021. Rheumatology (Oxford). Published 11 July 2023. doi:10.
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