Preprint: Trends in analgesia prescribing in primary care in Ireland and England between 2014 and 2022
We have completed an analysis of trends in analgesic use comparing Ireland and England. This study uses data from Ireland provides by the HSE Primary Care Reimbursement Services for people with General Medical Services (GMS) scheme eligibility, publicly available data from England.
The paper is currently under review, but a preprint version is now available to read on medRxiv.
Abstract
Background
Pain is a major public health issue, and a common reason people seek medical care. Pharmacological treatments depend on the type of pain and carry different risks and benefits. The aim of this study was to examine trends in analgesic prescribing in Ireland and England between 2014 and 2022.
Methods
Monthly data on medicines prescribed and dispensed in primary care were used. For Ireland, data on the means-tested General Medical Services (GMS) scheme were used, covering approximately 32% of the population. For England, data from the NHS Digital platform for all general practices were used. Outcomes were the volume of prescribed analgesic use, including rates of dispensings, costs, and standard doses (including oral morphine equivalents (OMEs) for opioids) per 1,000 population, summarised per year for each drug class/drug.
Results
In Ireland, the rate of analgesia dispensings increased between 2014 and 2022 for most drugs. Opioid dispensings increased from 979 to 1,220 per 1,000 population, while paracetamol increased from 1,295 to 1,824. Systemic NSAIDs decreased from 781 to 734. In England, most analgesia dispensing rates decreased, with opioids decreasing from 721 to 585 per 1,000 population, paracetamol from 734 to 484, and systemic NSAIDs from 259 to 167.
Discussion
Substantially different dispensing patterns were found in Ireland and England, with higher increasing overall rates in Ireland and lower decreasing rates in England, potentially driven by the older age and lower socioeconomic status of GMS patients in Ireland. Further research to understand drivers for this higher volume of use is required.