Professor ROGER KNAGGS's Outputs (60)

Analgesic utilization in people with knee osteoarthritis: A population-based study using primary care data (2023)
Journal Article
Taqi, A., Gran, S., & Knaggs, R. D. (2023). Analgesic utilization in people with knee osteoarthritis: A population-based study using primary care data. Pain Practice, https://doi.org/10.1111/papr.13212

Purpose: Osteoarthritis (OA) is a chronic painful condition that often affects large joints such as the knee. Treatment guidelines recommend paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids. Antidepressants and anti-epileptic d... Read More about Analgesic utilization in people with knee osteoarthritis: A population-based study using primary care data.

Logic model for opioid safety in chronic non-malignant pain management, an in-depth qualitative study (2022)
Journal Article
Anderson, C., Iqbal, A., Knaggs, R., & Toh, L. S. (2023). Logic model for opioid safety in chronic non-malignant pain management, an in-depth qualitative study. International Journal of Clinical Pharmacy, 45, 220-232. https://doi.org/10.1007/s11096-022-01493-6

Background Opioids are commonly used for the management of chronic non-malignant pain in Pakistan; but there is a lack of literature around precursors or motivators in the use of opioids.
Aim The study holistically explored factors contributing towa... Read More about Logic model for opioid safety in chronic non-malignant pain management, an in-depth qualitative study.

Misappropriation of the 1986 WHO analgesic ladder: the pitfalls of labelling opioids as weak or strong (2022)
Journal Article
Crush, J., Levy, N., Knaggs, R. D., & Lobo, D. N. (2022). Misappropriation of the 1986 WHO analgesic ladder: the pitfalls of labelling opioids as weak or strong. British Journal of Anaesthesia, 129(2), 137-142. https://doi.org/10.1016/j.bja.2022.03.004

Opioids have a vital role in alleviating pain from cancer and surgery. Despite good intentions, it is now recognised that the original WHO Cancer Pain Relief guidance from 1986, in which opioids were classified as either weak or strong, has been both... Read More about Misappropriation of the 1986 WHO analgesic ladder: the pitfalls of labelling opioids as weak or strong.

System-level policies on appropriate opioid use, a multi-stakeholder consensus (2022)
Journal Article
Forget, P., Patullo, C., Hill, D., Ambekar, A., Baldacchino, A., Cata, J., Chetty, S., Cox, F. J., de Boer, H. D., Dinwoodie, K., Dom, G., Eccleston, C., Fullen, B., Jutila, L., Knaggs, R. D., Lavand’homme, P., Levy, N., Lobo, D. N., Pogatzki-Zahn, E., Scherbaum, N., …Gilbert, S. (2022). System-level policies on appropriate opioid use, a multi-stakeholder consensus. BMC Health Services Research, 22(1), Article 329. https://doi.org/10.1186/s12913-022-07696-x

Background: This consensus statement was developed because there are concerns about the appropriate use of opioids for acute pain management, with opposing views in the literature. Consensus statement on policies for system-level interventions may he... Read More about System-level policies on appropriate opioid use, a multi-stakeholder consensus.

Association between mirtazapine use and serious self-harm in people with depression: an active comparator cohort study using UK electronic health records (2022)
Journal Article
Joseph, R. M., Jack, R. H., Morriss, R., Knaggs, R. D., Butler, D., Hollis, C., Hippisley-Cox, J., & Coupland, C. (2022). Association between mirtazapine use and serious self-harm in people with depression: an active comparator cohort study using UK electronic health records. Evidence-Based Mental Health, 25(4), 169-176. https://doi.org/10.1136/ebmental-2021-300355

BACKGROUND: Studies report an increased risk of self-harm or suicide in people prescribed mirtazapine compared with other antidepressants. OBJECTIVES: To compare the risk of serious self-harm in people prescribed mirtazapine versus other antidepressa... Read More about Association between mirtazapine use and serious self-harm in people with depression: an active comparator cohort study using UK electronic health records.

The risk of all-cause and cause-specific mortality in people prescribed mirtazapine: an active comparator cohort study using electronic health records (2022)
Journal Article
Joseph, R. M., Jack, R. H., Morriss, R., Knaggs, R. D., Butler, D., Hollis, C., Hippisley-Cox, J., & Coupland, C. (2022). The risk of all-cause and cause-specific mortality in people prescribed mirtazapine: an active comparator cohort study using electronic health records. BMC Medicine, 20(1), Article 43. https://doi.org/10.1186/s12916-022-02247-x

Background
Studies have reported an increased risk of mortality among people prescribed mirtazapine compared to other antidepressants. The study aimed to compare all-cause and cause-specific mortality between adults prescribed mirtazapine or other s... Read More about The risk of all-cause and cause-specific mortality in people prescribed mirtazapine: an active comparator cohort study using electronic health records.

Utility of unidimensional and functional pain assessment tools in adult postoperative patients: a systematic review (2022)
Journal Article
Baamer, R. M., Iqbal, A., Lobo, D. N., Knaggs, R. D., Levy, N. A., & Toh, L. S. (2022). Utility of unidimensional and functional pain assessment tools in adult postoperative patients: a systematic review. British Journal of Anaesthesia, 128(5), 874-888. https://doi.org/10.1016/j.bja.2021.11.032

Background: We aimed to appraise the evidence relating to the measurement properties of unidimensional tools to quantify pain after surgery. Furthermore, we wished to identify the tools used to assess interference of pain with functional recovery. Me... Read More about Utility of unidimensional and functional pain assessment tools in adult postoperative patients: a systematic review.

Association between opioid-related deaths and prescribed opioid dose and psychotropic medicines in England: a case-crossover study (2021)
Journal Article
Chen, T.-C., Knaggs, R. D., & Chen, L.-C. (2021). Association between opioid-related deaths and prescribed opioid dose and psychotropic medicines in England: a case-crossover study. British Journal of Anaesthesia, 127(5), 789-797. https://doi.org/10.1016/j.bja.2021.06.049

Background

Opioid-overdose deaths are associated with poisoning with prescription and illicit opioids in the USA. In contrast, opioid-related deaths (ORDs) in the UK often involve drugs and substances of misuse, and may not be associated with a hi... Read More about Association between opioid-related deaths and prescribed opioid dose and psychotropic medicines in England: a case-crossover study.

Association between opioid‐related deaths and persistent opioid prescribing in primary care in England: a nested case‐control study (2021)
Journal Article
Chen, T., Knaggs, R. D., & Chen, L. (2022). Association between opioid‐related deaths and persistent opioid prescribing in primary care in England: a nested case‐control study. British Journal of Clinical Pharmacology, 88(2), 798-809. https://doi.org/10.1111/bcp.15028

Aim
This study aimed to evaluate the association between opioid-related deaths and persistent opioid utilisation in the United Kingdom (UK).

Methods
This nested case-control study used the UK Clinical Practice Research Datalink, linking the Offi... Read More about Association between opioid‐related deaths and persistent opioid prescribing in primary care in England: a nested case‐control study.

Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: A scoping review (2021)
Journal Article
Evans, C., Poku, B. A., Pearce, R., Eldridge, J., Hendrick, P., Knaggs, R., Blake, H., Yogeswaran, G., McLuskey, J., Tomczak, P., Thow, R., Harris, P., Conway, J., & Collier, R. (2021). Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: A scoping review. BMJ Open, 11(8), Article e048171. https://doi.org/10.1136/bmjopen-2020-048171

Objectives In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertak... Read More about Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: A scoping review.

Collaboration between adult patients and practitioners when making decisions about prescribing opioid medicines for chronic non-cancer pain in primary care: a scoping review (2021)
Journal Article
Bathia, N. S., McAskill, R. E., Hancox, J. E., & Knaggs, R. D. (2022). Collaboration between adult patients and practitioners when making decisions about prescribing opioid medicines for chronic non-cancer pain in primary care: a scoping review. British Journal of Pain, 16(1), 119-126. https://doi.org/10.1177/20494637211025560

Background: Long-term opioid therapy (>12 months) is not effective for improving chronic non-cancer pain and function. Where patients are not experiencing pain relief with long-term opioids, the opioid should be tapered and discontinuation considered... Read More about Collaboration between adult patients and practitioners when making decisions about prescribing opioid medicines for chronic non-cancer pain in primary care: a scoping review.

Is Europe also facing an opioid crisis? ‐ A survey of European Pain Federation chapters (2021)
Journal Article
Häuser, W., Buchser, E., Finn, D., Dom, G., Fors, E., Heiskanen, T., Jarlbaek, L., Knaggs, R. D., Kosek, E., Krcevski – Škvarč, N., Pakkonen, K., Perrot, S., Trouvain, A., & Morlion, B. (2021). Is Europe also facing an opioid crisis? ‐ A survey of European Pain Federation chapters. European Journal of Pain, 25(8), 1760-1769. https://doi.org/10.1002/ejp.1786

Background

There is considerable public interest in whether Europe is facing an opioid crisis comparable to the one in the United States and the contribution of opioid prescriptions for pain to a potential opioid crisis.

Methods

A task force... Read More about Is Europe also facing an opioid crisis? ‐ A survey of European Pain Federation chapters.

Characterization and Associated Costs of Constipation Relating to Exposure to Strong Opioids in England: An Observational Study (2021)
Journal Article
Morgan, C. L., Jenkins-Jones, S., Knaggs, R., Currie, C., Conway, P., Poole, C. D., & Berni, E. (2021). Characterization and Associated Costs of Constipation Relating to Exposure to Strong Opioids in England: An Observational Study. Clinical Therapeutics, 43(6), 968-989. https://doi.org/10.1016/j.clinthera.2021.03.021

Purpose: Opioid use is associated with gastrointestinal adverse events, including nausea and constipation. We used a real-world dataset to characterize the health care burden associated with opioid-induced constipation (OIC) with particular emphasis... Read More about Characterization and Associated Costs of Constipation Relating to Exposure to Strong Opioids in England: An Observational Study.

Current Use of Analgesics and the Risk of Falls in people with Knee Osteoarthritis: A Population-based Cohort Study Using Primary Care and Hospital Records (2021)
Journal Article
Taqi, A., Gran, S., & Knaggs, R. D. (2021). Current Use of Analgesics and the Risk of Falls in people with Knee Osteoarthritis: A Population-based Cohort Study Using Primary Care and Hospital Records. Osteoarthritis and Cartilage, 3(2), Article 100165. https://doi.org/10.1016/j.ocarto.2021.100165

Objective

To examine the association between the current use of analgesics and the risk of falls in people with knee osteoarthritis (KOA).

Methods

A retrospective cohort study using data from the UK Clinical Practice Research Datalink, with... Read More about Current Use of Analgesics and the Risk of Falls in people with Knee Osteoarthritis: A Population-based Cohort Study Using Primary Care and Hospital Records.

Surgery and opioids: evidence-based expert consensus guidelines on the perioperative use of opioids in the United Kingdom (2021)
Journal Article
Srivastava, D., Hill, S., Carty, S., Rockett, M., Bastable, R., Knaggs, R., Lambert, D., Levy, N., Hughes, J., & Wilkinson, P. (2021). Surgery and opioids: evidence-based expert consensus guidelines on the perioperative use of opioids in the United Kingdom. British Journal of Anaesthesia, 126(6), 1208-1216. https://doi.org/10.1016/j.bja.2021.02.030

There are significant concerns regarding prescription and misuse of prescription opioids in the perioperative period. The Faculty of Pain Medicine at the Royal College of Anaesthetists have produced this evidence-based expert consensus guideline on s... Read More about Surgery and opioids: evidence-based expert consensus guidelines on the perioperative use of opioids in the United Kingdom.

PROTOCOL: A cohort study examining the association between mirtazapine and mortality risk in adults with a diagnosis of depression (2021)
Preprint / Working Paper
Joseph, R. M., Jack, R. H., Morriss, R., Knaggs, R. D., Hollis, C., Hippisley-Cox, J., & Coupland, C. PROTOCOL: A cohort study examining the association between mirtazapine and mortality risk in adults with a diagnosis of depression

This protocol describes a cohort study comparing the risks of mortality and serious self-harm (suicide or near-fatal deliberate self-harm) between adults with depression prescribed mirtazapine, a selective serotonin reuptake inhibitor (SSRI), amitrip... Read More about PROTOCOL: A cohort study examining the association between mirtazapine and mortality risk in adults with a diagnosis of depression.

Evidence-based clinical practice guidelines on the management of pain in older people – a summary report (2020)
Journal Article
Dunham, M., Schofield, P., & Knaggs, R. (2022). Evidence-based clinical practice guidelines on the management of pain in older people – a summary report. British Journal of Pain, 16(1), 6-13. https://doi.org/10.1177/2049463720976155

Objective: The objective of this study is to develop an update of the evidence-based guidelines for the management of pain in older people. Design: Review of evidence since 2010 using a systematic and consensus approach is performed. Results: Recogni... Read More about Evidence-based clinical practice guidelines on the management of pain in older people – a summary report.

Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review (2020)
Journal Article
Iqbal, A., Knaggs, R. D., Anderson, C., & Toh, L. S. (2022). Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review. Research in Social and Administrative Pharmacy, 18(3), 2352-2366. https://doi.org/10.1016/j.sapharm.2020.11.014

Background: Opioid optimisation is a global issue in Chronic Non-malignant Pain (CNMP) management. Objective: This systematic review aims to assess the effectiveness of interventions delivered by pharmacists in outpatient clinical settings, community... Read More about Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review.

The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety (2020)
Journal Article
Foo, I., Macfarlane, A. J. R., Srivastava, D., Bhaskar, A., Barker, H., Knaggs, R., Eipe, N., & Smith, A. F. (2021). The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety. Anaesthesia, 76(2), 238-250. https://doi.org/10.1111/anae.15270

Intravenous lidocaine is used widely for its effect on postoperative pain and recovery but it can be, and has been, fatal when used inappropriately and incorrectly. The risk‐benefit ratio of i.v. lidocaine varies with type of surgery and with patient... Read More about The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety.

Over-The-Counter Codeine: Can Community Pharmacy Staff Nudge Customers into Its Safe and Appropriate Use? (2020)
Journal Article
Mody, S., Kirkdale, C. L., Thornley, T., Dickinson, A., Avery, A. J., Knaggs, R., Rann, S., & Bastable, R. (2020). Over-The-Counter Codeine: Can Community Pharmacy Staff Nudge Customers into Its Safe and Appropriate Use?. Pharmacy, 8(4), Article 185. https://doi.org/10.3390/pharmacy8040185

The misuse of opioids, including codeine which is sold over-the-counter (OTC) in United Kingdom (UK) community pharmacies, is a growing public health concern. An educational Patient Safety Card was developed and piloted to see if it nudged customers... Read More about Over-The-Counter Codeine: Can Community Pharmacy Staff Nudge Customers into Its Safe and Appropriate Use?.