Socioeconomic status and use of analgesic drugs before and after primary hip arthroplasty: a population-based cohort study of 103,209 patients during 1996–2018

Abstract

Background and purpose — Total hip arthroplasty (THA) is an effective and common procedure. However, persistent pain and analgesic requirement up to 2 years after THA surgery are common. We examined the trends in the utilization of analgesics before and after THA, overall, and in relation to socioeconomic status (SES) in a populationbased cohort. Patients and methods — We used the Danish Hip Arthroplasty Register to identify 103,209 patients who underwent THA between 1996 and 2018. Data on prescriptions and SES markers was obtained from Danish medical databases. Prevalence rates of redeemed prescriptions for analgesics with 95% confidence intervals were calculated for 4 quarters before and 4 quarters after THA for the entire THA population, and by 3 SES markers (education, cohabiting status, and wealth). Results — Overall, the prevalence of analgesic use prior to surgery was 42% at 9–12 months and 59% at 0–3 months before the THA. The prevalence of analgesics reached its highest at 64% 0–3 months after THA but declined to 27% at 9–12 months after THA. Low education, living alone, and having low wealth (low SES) were associated with higher prevalence of analgesics use both before and after THA. Interpretation — 59% of patients used analgesics 0–3 months before surgery, which could indicate that THA might not be considered the last option for treatment and that surgery criteria might depend more on factors such as patient preferences or hip function. Moreover, health professionals should prioritize the use of a detailed plan when phasing out analgesics after THA to counteract unnecessary use, especially when treating patients with low SES.

Does preoperative opioid use predict outcomes to 6 months following primary unilateral knee or hip arthroplasty for osteoarthritis? A data-linked retrospective study

“…Public patients experiencing increased wait times for arthroplasty in the public health system may result in worse symptoms as well as progression of disease complexity [ 47 , 48 ], which may result in a higher prevalence of opioid use to manage their pain and maintain function. Furthermore, public patients in SWSLHD come from low socioeconomic class [ 49 ], thus increasing the prevalence of opioid use prior to arthroplasty [ 50 ].…”

Comparison between Ultrasound‐Guided Pericapsular Nerve Group Block and Local Infiltration Analgesia for Postoperative Analgesia after Total Hip Arthroplasty: A Prospective Randomized Controlled Trial

“…We recruited patients aged between 25 and 80 years, with normal quadriceps strength and ASA grade I-III, undergoing elective THA. The exclusion criteria were as follows: (1)…”

“…Total hip arthroplasty (THA) is a widely recognized surgical procedure in clinical practice, which can resolve hip pain and improve hip joint function 1,2 . Despite improvements in surgical techniques and implant longevity, some literature still reports postoperative dissatisfaction in patients that is most often related to poor postoperative pain control and prolonged recovery periods 3,4 .…”

“…Total hip arthroplasty (THA) is a widely recognized surgical procedure in clinical practice, which can resolve hip pain and improve hip joint function. 1 , 2 Despite improvements in surgical techniques and implant longevity, some literature still reports postoperative dissatisfaction in patients that is most often related to poor postoperative pain control and prolonged recovery periods. 3 , 4 If the pain is prolonged and persistent, the patient may refuse rehabilitation training, which can lead to more serious complications, such as deep vein thrombosis of the lower extremity.…”

Multimorbidity measured with Charlson Comorbidity Index is not associated with clinically relevant risk of revision after primary total hip arthroplasty: a population-based cohort study on 98,647 patients from the Danish Hip Arthroplasty Register

“…Due to different methods of measuring multimorbidity [ 2 ] the prevalence reported differs greatly, ranging from 13% to 73% [ 3 ]. Based on hospital contacts, the prevalence of multimorbidity was 25% in Denmark for patients who underwent THA due to osteoarthritis (OA) in 2018 [ 4 ]. In contrast, based on prescription data, a prevalence of 80% in 2018 was reported in Australia [ 5 ].…”