Trends in analgesia prescribing in primary care in Ireland and England between 2014 and 2022: A repeated...

Analgesic medicines are an important component of pain management, with different medicines carrying different risks and benefits. The aim of this study was to examine trends in analgesic prescribing in Ireland and England between 2014 and 2022.

Monthly data on medicines prescribed and dispensed in primary care were used. For Ireland, data comprised medicines prescribed through the means-tested General Medical Services (GMS), covering approximately 32% of the population, while for England, data consisted of medicines prescribed through all general practices. Outcomes included rates of dispensings, costs and standard doses (including oral morphine equivalents [OMEs] for opioids) per 1000 population, summarized per year for each drug class and drug.

In Ireland, the rate of analgesia dispensings increased between 2014 and 2022 for most drugs. Opioid dispensings increased from 979 to 1220 per 1000 population (+25%), while paracetamol increased from 1295 to 1824 (+41%). Systemic NSAIDs decreased from 781 to 734 (-6%). In England, most analgesia dispensing rates decreased, with opioids decreasing from 721 to 585 per 1000 population (-19%), paracetamol from 734 to 484 (-34%) and systemic NSAIDs from 259 to 167 (-35%).

Substantially different dispensing patterns were found in Ireland and England, with dispensing rates in Ireland generally higher and increasing between 2014 and 2022 and rates in England generally lower and decreasing. This discrepancy is likely largely driven by the older age and lower socioeconomic status of GMS patients; however, further research to understand the drivers for this high volume of use is required.