Trends and factors associated with prescription opioid utilisation, dependence and deaths in patients with musculoskeletal conditions

In new opioid users with the following RMDs: rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, osteoarthritis and fibromyalgia to:

• Characterise national UK opioid prescribing trends between 2006-2019
• Evaluate trends in hospital admissions associated with opioid-related prescriptions, dependence and mortality
• Identify individual, prescribing, demographic and contextual risk factors that predispose to opioid-dependence and mortality
• Predict opioid-related mortality risk to enable a stratified approach to prescribing in clinical care

Month 6: Obtain linked data, prepare datasetsfor analysis, characterise study population including subpopulations for each condition using established algorithms
Month 12: Describe national opioid prescribing trends between 2006-19 for each condition
Month 18: Prepare and analyse data on hospital admissions related to opioids, opioid-related dependence and opioid-related mortality
Month 24: Complete analysis using multi-statemodel to assess individual, prescribing and contextual risk factors that predispose to opioid-dependence and mortality
Month 30: completed by month 36: Complete analysis using ML to identify individual and subgroup risk of death
Months 7-36: Submit publications and final dissemination of results

This project has been informed and revised as per recommendations from our Research User Group, a group of lay individuals with a musculoskeletal condition. Two patient partners will be involved in all phases of the research to improve the relevance, quality and validity. One has been prescribed a number of opioids for osteoarthritis and experienced a range of opioid-related harms. The other has fibromyalgia and is also affiliated with Versus Arthritis and Fibromyalgia Action UK. Having experienced both the benefits and harms of opioids personally, they are well-informed and passionate about the outlined work. They will attend relevant meetings, help with the interpretation of results and disseminate findings by tailoring key messages to patients and stakeholders including patient pain organisations.