Osteoarthritis of the knee clinical care standard indicators: 5c-Proportion of patients prescribed opioids for longer than three months for the management of pain associated with knee osteoarthritis

Collection and usage attributes

45 years

Presented as a percentage.

Health services determine the number of patients prescribed opioids for longer than three months through an audit of all the patients with knee osteoarthritis at a particular point in time.

(Numerator ÷ denominator) x 100

Number of patients prescribed opioids for longer than three months for the management of pain associated with knee osteoarthritis.

Number of patients with knee osteoarthritis prescribed opioids.

If opioids are used, they should be prescribed on a short-term basis, with regular review of treatment response and adverse effects.

A clear plan for ceasing ineffective therapy should be in place and discussed with the patient. If treatment response is inadequate, caution should be exercised when increasing the dose of opioids as there is an increased risk of harm and potentially no added benefit.

Prolonged use of opioids indicates the need for specialist assessment.

Note that health services may not necessarily achieve 0% for this indicator, even when providing appropriate treatment, as there may be patients for whom opioids are the most appropriate drug for longer than three months. In these instances, this indicator should be used to review the appropriateness of the use of opioids for longer than three months for these patients, and to monitor the health service’s level of use of opioids over time.

Representational attributes

N[NN]

Accountability attributes

Applicable setting: primary and specialist care (including hospital-based specialist care).

Source and reference attributes

Nuesch E, Rutjes AW, Husni E, Welch V & Juni P 2009. Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database of Systematic Reviews(4): CD003115.