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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.

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., …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, 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.

Opioids and the risk of fracture: a self-controlled case series study in the Clinical Practice Research Datalink (2021)
Journal Article
Peach, E., Pearce, F., Gibson, J., Cooper, A., Chen, L., & Knaggs, R. (2021). Opioids and the risk of fracture: a self-controlled case series study in the Clinical Practice Research Datalink. American Journal of Epidemiology, 190(7), 1324-1331. https://doi.org/10.1093/aje/kwab042

Self-controlled study designs can be used to assess the association between exposures and acute outcomes while controlling for important confounders. Using routinely collected health data, a self-controlled case series design was used to investigate... Read More about Opioids and the risk of fracture: a self-controlled case series study in the Clinical Practice Research Datalink.

PROTOCOL: A cohort study examining the association between mirtazapine and mortality risk in adults with a diagnosis of depression (2021)
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.

Characterising the evidence base for advanced clinical practice in the UK: A scoping review protocol (2020)
Journal Article
Evans, C., Poku, B., Pearce, R., Eldridge, J., Hendrick, P., Knaggs, R., …Collier, R. (2020). Characterising the evidence base for advanced clinical practice in the UK: A scoping review protocol. BMJ Open, 10(5), Article e036192. https://doi.org/10.1136/bmjopen-2019-036192

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Introduction A global health workforce crisis, coupled with ageing populations, wars and the rise of non-com... Read More about Characterising the evidence base for advanced clinical practice in the UK: A scoping review protocol.

Secondary care specialist visits made by children and young people prescribed antidepressants in primary care: A descriptive study using the QResearch database (2020)
Journal Article
Jack, R. H., Joseph, R. M., Coupland, C., Butler, D., Hollis, C., Morriss, R., …Hippisley-Cox, J. (2020). Secondary care specialist visits made by children and young people prescribed antidepressants in primary care: A descriptive study using the QResearch database. BMC Medicine, 18(1), https://doi.org/10.1186/s12916-020-01560-7

© 2020 The Author(s). Background: Antidepressants may be used to manage a number of conditions in children and young people including depression, anxiety, and obsessive-compulsive disorder. UK guidelines for the treatment of depression in children an... Read More about Secondary care specialist visits made by children and young people prescribed antidepressants in primary care: A descriptive study using the QResearch database.

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), 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.