Research study finds substantial and sustained prescribing of pain medicines to patients with inflammatory arthritis page thumbnail

Dr Ian Scott, who is a Consultant Rheumatologist at MPFT and Honorary Senior Lecturer in Keele University’s School of Medicine and is funded by the National Institute for Health Research (NIHR), has played a leading role on a study examining pain medicine prescribing in patients with inflammatory arthritis.

The study, published in the Oxford University Press Rheumatology journal, looked at the prescribing of pain medicines in the medical records of over 1,000 people with inflammatory arthritis from 2000 to 2015. Apart from oral NSAIDs in patients with spinal inflammation, previous research has shown only limited evidence that pain medicines may improve symptoms in some patients with inflammatory arthritis, but often have side-effects, which can be severe.

The study found that up to three quarters of patients with inflammatory arthritis received a pain medicine prescription in each year, with at least one in three receiving a long-term opioid prescription. It also showed that prescription rates for oral non-steroidal anti-inflammatory drugs (NSAIDs) have fallen significantly since 2004. This coincides with a series of nationwide recommendations to prescribe them more safely, owing to the link some oral NSAIDs have with heart attacks and strokes.

Dr Scott said: “Our study has shown there is substantial and sustained prescribing of pain medicines, particularly of opioids, to patients with inflammatory arthritis in the English NHS. As there is generally only limited evidence that pain medicines may help inflammatory arthritis pain in some patients, but substantial evidence they can cause harm, this finding is concerning.”

“There are many other ways to help patients with inflammatory arthritis manage their pain. These include reducing joint inflammation using specialist disease-modifying medicines, exercise, and talking therapy treatments. Our study suggests we need to move the focus of pain care for people with inflammatory arthritis away from the long-term prescribing of pain medicines like opioids, and towards the use of these other treatment approaches.”