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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

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 5c-Proportion of patients prescribed opioids for longer than three months for the management of pain associated with knee osteoarthritis
METeOR identifier:Help on this term644310
Registration status:Help on this termHealth, Standard 02/08/2017
Description:Help on this term

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

Rationale:Help on this term

Opioids are associated with adverse events (including dependence), which are sometimes very serious (Nuesch et al. 2009). There are additional risks for older people, where the increased likelihood of a fall with opioid use can lead to serious fractures.

Indicator set:Help on this termClinical care standard indicators: osteoarthritis of the knee Health, Standard 02/08/2017

Collection and usage attributes

Population group age from:Help on this term

45 years

Computation description:Help on this term

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.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

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

Denominator:Help on this term

Number of patients with knee osteoarthritis prescribed opioids.

Comments:Help on this term

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

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN]

Accountability attributes

Other issues caveats:Help on this term

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

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

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.

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