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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., …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.

Opioid prescription at postoperative discharge: a retrospective observational cohort study (2021)
Journal Article
Daliya, P., Adiamah, A., Roslan, F., Theophilidou, E., Knaggs, R., Levy, N., & Lobo, D. (2021). Opioid prescription at postoperative discharge: a retrospective observational cohort study. Anaesthesia, 76(10), 1367-1376. https://doi.org/10.1111/anae.15460

Opioid misuse is now considered a major public health epidemic in North America, with substantial social and financial consequences. As well as socio-economic and commercial drivers, modifiable risk-factors that have resulted in this crisis have been... Read More about Opioid prescription at postoperative discharge: a retrospective observational cohort study.

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., …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., …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?.

An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients (2020)
Journal Article
Levy, N., Quinlan, J., El‐Boghdadly, K., Fawcett, W. J., Agarwal, V., Bastable, R. B., …Macintyre, P. E. (2020). An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients. Anaesthesia, 76(4), 520-536. https://doi.org/10.1111/anae.15262

This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri‐operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postopera... Read More about An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients.

Incidence and prevalence of primary care antidepressant prescribing in children and young people in England, 1998-2017: A population-based cohort study (2020)
Journal Article
Jack, R. H., Hollis, C., Coupland, C., Morriss, R., Knaggs, R. D., Butler, D., …Hippisley-Cox, J. (2020). Incidence and prevalence of primary care antidepressant prescribing in children and young people in England, 1998-2017: A population-based cohort study. PLoS Medicine, 17(7), Article e1003215. https://doi.org/10.1371/journal.pmed.1003215

BACKGROUND: The use of antidepressants in children and adolescents remains controversial. We examined trends over time and variation in antidepressant prescribing in children and young people in England and whether the drugs prescribed reflected UK l... Read More about Incidence and prevalence of primary care antidepressant prescribing in children and young people in England, 1998-2017: A population-based cohort study.

Particulate steroids in axial spinal blockade and the increasing role of patient consent: Les grains de sable dans l’engrenage (2020)
Journal Article
Munglani, R., Knaggs, R., & Eyre, G. (2020). Particulate steroids in axial spinal blockade and the increasing role of patient consent: Les grains de sable dans l’engrenage. British Journal of Pain, 14(2), 141-146. https://doi.org/10.1177/2049463720921199

The complexity of modern medical practice is such that it is very unlikely that on any single issue we can give a definitive answer in any circumstance, and in our view the medical debate as to the use of particulate corticosteroid medicines in axial... Read More about Particulate steroids in axial spinal blockade and the increasing role of patient consent: Les grains de sable dans l’engrenage.

Impact of smoking status on the efficacy of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review (2020)
Journal Article
Sonnex, K., Alleemudder, H., & Knaggs, R. (2020). Impact of smoking status on the efficacy of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review. BMJ Open, 10(4), Article e037509. https://doi.org/10.1136/bmjopen-2020-037509

Objectives: Inhaled corticosteroids (ICS) reduce exacerbation rates and the decline in lung function in people with chronic obstructive pulmonary disease (COPD). There is evidence that smoking causes ‘steroid resistance’ and thus reduces the effect o... Read More about Impact of smoking status on the efficacy of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review.

Trends in antidepressant prescriptions in children and young people in England, 1998-2017: protocol of a cohort study using linked primary care and secondary care datasets (2019)
Journal Article
Jack, R. H., Hollis, C., Coupland, C., Morriss, R., Knaggs, R. D., Cipriani, A., …Hippisley-Cox, J. (2019). Trends in antidepressant prescriptions in children and young people in England, 1998-2017: protocol of a cohort study using linked primary care and secondary care datasets. Evidence-Based Mental Health, 22(3), 129-133. https://doi.org/10.1136/ebmental-2019-300097

Introduction Increasing numbers of children and young people (CYP) are receiving prescriptions for antidepressants. This is the protocol of a study aiming to describe the trends and variation in antidepressant prescriptions in CYP in England, and t... Read More about Trends in antidepressant prescriptions in children and young people in England, 1998-2017: protocol of a cohort study using linked primary care and secondary care datasets.

Prescription opioids: regional variation and socioeconomic status: evidence from primary care in England (2019)
Journal Article
Chen, T.-C., Chen, L.-C., Kerry, M., & Knaggs, R. D. (2019). Prescription opioids: regional variation and socioeconomic status: evidence from primary care in England. International Journal of Drug Policy, 64, 87-94. https://doi.org/10.1016/j.drugpo.2018.10.013

Background: This study aimed to quantify dispensed opioid prescriptions among primary care practices throughout England and investigate its association with socioeconomic status (SES). Methods: This cross-sectional study used publicly available data... Read More about Prescription opioids: regional variation and socioeconomic status: evidence from primary care in England.

A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom (2017)
Journal Article
Chen, T.-C., Chen, L.-C., & Knaggs, R. D. (2018). A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom. Pharmacoepidemiology and Drug Safety, 27(5), 487-494. https://doi.org/10.1002/pds.4320

Purpose This study aimed to develop hypotheses to explain the increasing tramadol utilisation, evaluate the impact of tramadol classification, and explore the trend between tramadol utilisation and related deaths in the United Kingdom. Methods... Read More about A 15-year overview of increasing tramadol utilisation and associated mortality and the impact of tramadol classification in the United Kingdom.

Rapid acting fentanyl formulations in breakthrough pain in cancer: drug selection by means of the System of Objectified Judgement Analysis (2017)
Journal Article
Janknegt, R., van den Beuken, M., Schiere, S., Überall, M., Knaggs, R., Hanley, J., & Thronaes, M. (in press). Rapid acting fentanyl formulations in breakthrough pain in cancer: drug selection by means of the System of Objectified Judgement Analysis. European Journal of Hospital Pharmacy, 25(3), https://doi.org/10.1136/ejhpharm-2016-001127

Drug selection of rapid acting fentanyl formulations in the treatment of breakthrough pain in patients with cancer is performed by the System of Objectified Judgement Analysis method. All seven available formulations were included in the analysis. Th... Read More about Rapid acting fentanyl formulations in breakthrough pain in cancer: drug selection by means of the System of Objectified Judgement Analysis.