The impact of the COVID-19 pandemic on community prescription of opioid and antineuropathic analgesics for cancer patients in Wales, UK

Jun Han, Martin Rolles*, Fatemeh Torabi, Rowena Griffiths, Stuart Bedston, Ashley Akbari, Bruce Burnett, Jane Lyons, Giles Greene, Rebecca Thomas, Tamsin Long, Cathy Arnold, Dyfed Wyn Huws, Mark Lawler, Ronan A. Lyons

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Purpose
Public health measures instituted at the onset of the COVID-19 pandemic in the UK in 2020 had profound effects on the cancer patient pathway. We hypothesise that this may have affected analgesic prescriptions for cancer patients in primary care.

Methods
A whole-nation retrospective, observational study of opioid and antineuropathic analgesics prescribed in primary care for two cohorts of cancer patients in Wales, using linked anonymised data to evaluate the impact of the pandemic and variation between different demographic backgrounds.

Results
We found a significant increase in strong opioid prescriptions during the pandemic for patients within their first 12 months of diagnosis with a common cancer (incidence rate ratio (IRR) 1.15, 95% CI: 1.12–1.18, p < 0.001 for strong opioids) and significant increases in strong opioid and antineuropathic prescriptions for patients in the last 3 months prior to a cancer-related death (IRR = 1.06, 95% CI: 1.04–1.07, p < 0.001 for strong opioids; IRR = 1.11, 95% CI: 1.08–1.14, p < 0.001 for antineuropathics). A spike in opioid prescriptions for patients diagnosed in Q2 2020 and those who died in Q2 2020 was observed and interpreted as stockpiling. More analgesics were prescribed in more deprived quintiles. This differential was less pronounced in patients towards the end of life, which we attribute to closer professional supervision.

Conclusions
We demonstrate significant changes to community analgesic prescriptions for cancer patients related to the UK pandemic and illustrate prescription patterns linked to patients’ demographic background.

Original languageEnglish
Article number531
Number of pages12
JournalSupportive Care in Cancer
Volume31
Issue number9
Early online date22 Aug 2023
DOIs
Publication statusPublished - 01 Sept 2023

Keywords

  • Pain
  • Cancer
  • Primary care
  • Prescription
  • Analgesia
  • COVID-19 pandemic

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