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Analgesic Utilisation in People with Knee Osteoarthritis: A Population‐ Based Study Using Primary Care Data

Taqi, Aqila; Gran, Sonia; Knaggs, Roger D.


Aqila Taqi

Associate Professor



Osteoarthritis (OA) is a chronic painful condition that often affects large joints such as the knee. Treatment guidelines recommend paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. Antidepressants and Anti-epileptic drugs (AEDs) are commonly prescribed for chronic non-cancer pain conditions including OA, as an off-label use. This study describes analgesic utilisation in patients with knee OA at population-level using standard pharmaco-epidemiological methods.

This was a cross-sectional study between 2000 and 2014 using data from the UK Clinical Practice Research Datalink (CPRD). The use of antidepressants, AEDs, opioids, NSAIDs and paracetamol was studied in adults with knee OA using the following measures: annual number of prescriptions, Defined Daily Doses (DDD), oral morphine equivalent dose (OMEQ) and days’ supply.

In total, there were 8,944,381 prescriptions prescribed for 117,637 patients with knee OA during the 15-year period. There was a steady increase in the prescribing of all drug classes, except for NSAIDs, over the study period. Opioids were the most prevalent class prescribed in every study year. Tramadol was the most commonly prescribed opioid, with the number of DDD increasing from 0.11 to 0.71 DDDs per 1000 registrants in 2000 and 2014, respectively. The largest increase in prescribing was for AEDs, where the number of prescriptions increased from 2 to 11 per 1000 CPRD registrants.

There was an overall increase in the prescribing of analgesics apart from NSAIDs. Opioids were the most frequently prescribed class however, the greatest increase in prescribing between 2000 and 2014, was observed in AEDs.


Taqi, A., Gran, S., & Knaggs, R. D. (2023). Analgesic Utilisation in People with Knee Osteoarthritis: A Population‐ Based Study Using Primary Care Data. Pain Practice,

Journal Article Type Article
Acceptance Date Feb 1, 2023
Online Publication Date Feb 28, 2023
Publication Date Feb 28, 2023
Deposit Date Feb 21, 2023
Publicly Available Date Feb 29, 2024
Journal Pain Practice
Print ISSN 1530-7085
Electronic ISSN 1533-2500
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords Anesthesiology and Pain Medicine, Osteoarthritis, Drug-utilisation, Analgesics, Antidepressants, Anti-epileptic drugs
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