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Surgery delays linked to rise in opioid prescribing

Wednesday September 15th 2021

A steep rise in opioid prescriptions since the start of the COVID-19 pandemic may be linked to growing waiting lists, researchers warn today.

Writing in BMJ Quality & Safety, Dr Luke Farrow of the University of Aberdeen, UK, and colleagues outline their study of patients using opioids while waiting for surgery.

The team analysed prescribing information on 452 NHS patients in the north east of Scotland, on waiting lists for hip and knee replacement surgery, and compared it with prescriptions for similar patients pre-COVID.

It is estimated that around six million elective orthopaedic procedures were cancelled worldwide during the first peak of the pandemic. In the UK, surgery waiting times have been an average of 90 days longer during the pandemic than before.

This showed that prescribing of opioids such as morphine and tramadol are up by 40% compared with pre-pandemic levels.

Dr Farrow said: “COVID-19 has had a significant detrimental effect on access to hip and knee surgery, and work by others has suggested this has been associated with worsening pain and quality of life for patients.

“Our work provides evidence of potential for an emerging opioid problem associated with the influence of COVID-19 on elective orthopaedic services."

He warned that continued delays are expected for some time due to the backlog, adding: “We would advocate that health care professionals and patients avoid the use of opioid medication if at all possible due to the known lack of effect in this setting and potential for harm.

“We urgently need to find better alternative methods for managing severe arthritis pain for those awaiting this type of surgery and work to recover the backlog of associated operative cancellations during COVID-19 to prevent more widespread opioid use.”

Farrow, L. et al. BMJ Quality & Safety 15 September 2021

Tags: Flu & Viruses | NHS | Pharmaceuticals | UK News | World Health

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