Evaluating opioid use and safety in new users using linked EHRs

• Research type

  Research Study

• Full title

  Using linked secondary and primary care electronic health records to evaluate opioid utilisation and safety

• IRAS ID

  290133

• Contact name

  Meghna Jani

• Contact email

  meghna.jani@manchester.ac.uk

• Sponsor organisation

  University of Manchester

• Duration of Study in the UK

  5 years, 0 months, 0 days

• Research summary

  Opioid use and related harmful effects are rising in the US and worldwide. In the UK, hospital admissions due to opioid-related poisoning including prescription opioids (such as codeine, tramadol, oxycodone) have doubled over a decade. Pain due to musculoskeletal conditions and after surgery, are the top reasons for prescribing opioids for the first-time. Those who have surgery due to musculoskeletal problems (e.g. joint replacements) may be particularly vulnerable to experience opioid-related harms due to older age, other health-conditions and drug-interactions, compared to other surgeries. Additionally, some patients may be prescribed opioids when not required, for longer than needed or may develop long-term persistent opioid-use, which can be associated with serious harms and premature death.
  We will focus on patients starting opioids in hospital including those who undergo major surgeries to address key questions:
  (1) Who is most likely to receive opioids during a hospital stay and is prescribing appropriate in relation to patient-reported pain?
  (2) Which opioid prescribing-patterns and patient subgroups are associated with prolonged continued use after discharge?
  (3) What risk-factors lead to opioid-related harms and what proportion of patients experience them up to 1-year after surgery.
  Linked electronic health records (EHR) from hospital (single site), intermediate care and GP practices from Salford will be used. The Salford EHR system has several benefits including an electronic prescribing system. This captures whether a nurse actually administered the drug to the patient providing more accurate information (compared to if a doctor simply prescribed it). Important information collected when a patient is admitted to hospital, such as their falls risk and how frail they are, can allow adjustment for these differences between groups using statistical techniques. Additionally hospital data is linked to primary and intermediate care already for clinical purposes. The study does not require any active patient participation, as it uses previously collected data
  

• REC name

  West Midlands - Solihull Research Ethics Committee

• REC reference

  22/WM/0006

• Date of REC Opinion

  17 Jan 2022

• REC opinion

  Favourable Opinion