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

Taqi, Aqila; Gran, Sonia; Knaggs, Roger David

Abstract

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 linkage to Hospital Episode Statistics data. People diagnosed with KOA in England between 2000 and 2014 were included. The studied analgesic classes were antidepressants, antiepileptic drugs (AEDs), opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol. Cox Proportional Hazards model was used to estimate the risk of fall with current use of analgesics within one year of KOA diagnosis, reported as Hazard Ratio (HR) with 95% Confidence Intervals (CI).

Results

This study included 57,383 patients (mean age [SD] 67.0 [12.8] years, 59.3% were female); 44,010 (76.7%) were prescribed analgesics at least once within one year of KOA diagnosis. Within the first six months of KOA diagnosis, the reported HR (95%CI) were 1.46 (1.20, 1.78), 1.40 (0.91, 2.16), 2.40 (2.01, 2.85), 1.72 (1.43, 2.07), 1.98 (1.68, 2.33), while between 6 and 12 months after KOA diagnosis, the HR (95%CI) were 2.68 (2.14, 3.36), 2.22 (1.70, 2.91), 1.96 (1.70, 2.26), 1.47 (1.21, 1.78), 1.92 (1.63, 2.26) for antidepressants, AEDs, opioids, NSAIDs and paracetamol, respectively and adjusted for important potential confounders.

Conclusion

The current use of analgesics was associated with an increased risk of falls within one year of KOA diagnosis. These findings identify people with KOA who use analgesics as a priority for fall prevention programs/interventions, in an effort to optimise safety of analgesics in this population.

Citation

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

• Journal Article Type: Article
• Acceptance Date: Apr 6, 2021
• Online Publication Date: Apr 14, 2021
• Publication Date: 2021-06
• Deposit Date: Apr 21, 2021
• Publicly Available Date: Apr 21, 2021
• Journal: Osteoarthritis and Cartilage Open
• Print ISSN: 1063-4584
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 2
• Article Number: 100165
• DOI: https://doi.org/10.1016/j.ocarto.2021.100165
• Public URL: https://nottingham-repository.worktribe.com/output/5470185
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2665913121000285