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Guidelines Peri-operative pain management in adults: a multidisciplinary consensus statement from the Association of Anaesthetists and the British Pain Society (2024)
Journal Article
El-Boghdadly, K., Levy, N. A., Fawcett, W. J., Knaggs, R. D., Laycock, H., Baird, E., …Lobo, D. N. (in press). Guidelines Peri-operative pain management in adults: a multidisciplinary consensus statement from the Association of Anaesthetists and the British Pain Society. Anaesthesia,

This is a consensus document produced by expert members of a Working Party established by the Association of Anaesthetists and the British Pain Society. It has been seen and approved by their Committee and Board respectively. It is supported by the E... Read More about Guidelines Peri-operative pain management in adults: a multidisciplinary consensus statement from the Association of Anaesthetists and the British Pain Society.

“Application of five different strategies to define a cohort of patients with knee osteoarthritis in a large primary care database” (2024)
Journal Article
Taqi, A., Gran, S., & Knaggs, R. D. (2024). “Application of five different strategies to define a cohort of patients with knee osteoarthritis in a large primary care database”. Journal of Evaluation in Clinical Practice, https://doi.org/10.1111/jep.14045

Background Electronic health records (EHR) are frequently used for epidemiological research including drug utilisation studies in a defined population such as the population with knee osteoarthritis (KOA). We sought to describe the process of defi... Read More about “Application of five different strategies to define a cohort of patients with knee osteoarthritis in a large primary care database”.

Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study (2024)
Journal Article
Woodcock, C., Cornwall, N., Dikomitis, L., Harrisson, S. A., White, S., Helliwell, T., …Jinks, C. (in press). Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study. BJGP Open, BJGPO.2023.0221. https://doi.org/10.3399/BJGPO.2023.0221

Opioids are frequently prescribed for persistent non-cancer pain despite limited evidence of long-term effectiveness and risk of harm. Evidence-based interventions to address inappropriate opioid prescribing are lacking. To explore perspectives of pe... Read More about Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study.

Acceptability of a proposed practice pharmacist-led review for opioid-treated patients with persistent pain: A qualitative study to inform intervention development (2023)
Journal Article
Cornwall, N., Knaggs, R., Woodcock, C., Ashworth, J., Harrisson, S. A., Dikomitis, L., …on behalf of the PROMPPT team. (2024). Acceptability of a proposed practice pharmacist-led review for opioid-treated patients with persistent pain: A qualitative study to inform intervention development. British Journal of Pain, 18(3), 274-291. https://doi.org/10.1177/20494637231221688

Introduction Regular review of patients prescribed opioids for persistent non-cancer pain (PCNP) is recommended but not routinely undertaken. The PROMPPT (Proactive clinical Review of patients taking Opioid Medicines long-term for persistent Pain led... Read More about Acceptability of a proposed practice pharmacist-led review for opioid-treated patients with persistent pain: A qualitative study to inform intervention development.

Health economic impact of moderate-to-severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data (2023)
Journal Article
Coates, G., Clewes, P., Lohan, C., Stevenson, H., Wood, R., Tritton, T., …Walsh, D. (2023). Health economic impact of moderate-to-severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data. BMJ Open, 13(7), Article e067545. https://doi.org/10.1136/bmjopen-2022-067545

Objective: Despite the prevalence of osteoarthritis (OA) in England, few studies have examined the health economic impact of chronic pain associated with OA. The aim of this study was to compare outcomes in patients with moderate-to-severe chronic pa... Read More about Health economic impact of moderate-to-severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data.

Predictors of persistent postoperative opioid use following colectomy: a population‐based cohort study from England (2023)
Journal Article
Baamer, R. M., Humes, D. J., Toh, L. S., Knaggs, R. D., & Lobo, D. N. (2023). Predictors of persistent postoperative opioid use following colectomy: a population‐based cohort study from England. Anaesthesia, 78(9), 1081-1092. https://doi.org/10.1111/anae.16055

This retrospective cohort study on adults undergoing colectomy from 2010 to 2019 used linked primary (Clinical Practice Research Datalink), and secondary (Hospital Episode Statistics) care data to determine the prevalence of persistent postoperative... Read More about Predictors of persistent postoperative opioid use following colectomy: a population‐based cohort study from England.

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., …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.

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., …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.

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., …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.

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., …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.

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.