Opioid prescriptions after knee replacement: a retrospective study of pathways and prognostic factors in the Swiss healthcare setting

ObjectivesThe optimal use of opioids after knee replacement (KR) remains to be determined, given the growing evidence that opioids are no more effective than other analgesics and that their adverse effects can impair quality of life. Therefore, the objective is to examine opioid prescriptions after KR.DesignIn this retrospective study, we used descriptive statistics and estimated the association of prognostic factors using generalised negative binomial models.SettingThe study is based on anonymised claims data of patients with mandatory health insurance at Helsana, a leading Swiss health insurance.ParticipantsOverall, 9122 patients undergoing KR between 2015 and 2018 were identified.Primary and secondary outcome measuresBased on reimbursed bills, we calculated the dosage (morphine equivalent dose, MED) and the episode length (acute: