BACKGROUND AND PURPOSE Numbers on opioid prescriptions over time in arthroplasty patients are currently lacking. Therefore we determined the annual opioid prescribing rate in patients who received a hip/knee arthroplasty (HA/KA) between 2013 and 2018. PATIENTS AND METHODS The Dutch Foundation for Pharmaceutical Statistics, which provides national coverage of medication prescriptions, was linked to the Dutch Arthroplasty Register, which provides arthroplasty procedures. The opioid prescription rates were expressed as the number of defined daily dosages (DDD) and morphine milligram equivalent (MME) per person year (PY) and stratified for primary and revision arthroplasty. Amongst subgroups for age (< 75; ≥ 75 years) and sex for primary osteoarthritis arthroplasties, prescription rates stratified for opioid type (weak/strong) and prevalent preoperative opioid prescriptions (yes/no) were assessed. RESULTS 48,051 primary KAs and 53,964 HAs were included, and 3,540 revision KAs and 4,118 HAs. In 2013, after primary KA 58% were dispensed ≥ 1 opioid within the first year; this increased to 89% in 2018. For primary HA these numbers increased from 38% to 75%. In KAs the prescription rates increased from 13.1 DDD/PY to 14.4 DDD/PY, mainly due to oxycodone prescriptions (2.9 DDD/PY to 7.3 DDD/PY), while tramadol decreased (7.3 DDD/PY to 4.6 DDD/PY). The number of MME/PY also increased (888 MME/PY to 1224 MME/PY). Similar changes were observed for HA and revision arthroplasties. Irrespective of joint, prescription of opioid medication increased over time, with highest levels in groups with preoperative opioid prescriptions while weak opioid prescriptions decreased. INTERPRETATION In the Netherlands, between 2013 and 2018 postoperative opioid prescriptions after KA and HA increased, mainly due to increased oxycodone prescriptions with highest levels after surgeries with preoperative prescriptions.

中文翻译：

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膝关节和髋关节置换术后的阿片类药物处方模式：2013 年至 2018 年荷兰全国队列研究。

背景和目的 目前缺乏关节置换术患者阿片类药物处方的数据。因此，我们确定了 2013 年至 2018 年间接受髋/膝关节置换术 (HA/KA) 的患者的年度阿片类药物处方率。 Arthroplasty Register，提供关节成形术程序。阿片类药物处方率表示为每人年 (PY) 规定的每日剂量 (DDD) 和吗啡毫克当量 (MME) 的数量，并针对初次和翻修关节成形术进行分层。在年龄（< 75；≥ 75 岁）和原发性骨关节炎关节置换术的性别亚组中，评估了按阿片类药物类型（弱/强）和普遍的术前阿片类药物处方（是/否）分层的处方率。结果 纳入了 48,051 个初次 KA 和 53,964 个 HA，以及 3,540 个翻修 KA 和 4,118 个 HA。2013 年，58% 的原发性 KA 患者在第一年内分配了 ≥ 1 种阿片类药物；这在 2018 年增加到 89%。对于初级 HA，这些数字从 38% 增加到 75%。在 KAs 中，处方率从 13.1 DDD/PY 增加到 14.4 DDD/PY，主要是由于羟考酮处方（2.9 DDD/PY 到 7.3 DDD/PY），而曲马多减少（7.3 DDD/PY 到 4.6 DDD/PY）。MME/PY 的数量也有所增加（888 MME/PY 至 1224 MME/PY）。在 HA 和翻修关节置换术中观察到类似的变化。无论关节如何，阿片类药物的处方都会随着时间的推移而增加，在术前阿片类药物处方组中水平最高，而弱阿片类药物处方减少。解释 在荷兰，2013 年至 2018 年间，KA 和 HA 术后阿片类药物处方增加，这主要是由于术前处方增加了术后最高水平的羟考酮处方。