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Objective: Despite its association with poorer outcomes, opioid use in inflammatory bowel disease (IBD) is not well characterised in the UK. We aimed to examine the extent of opioid use, the associated factors and the use of mitigation techniques such as pain-service review and opioid weaning plans among individuals with IBD. Methods: Data were collected from consecutive patients attending IBD outpatient appointments at 12 UK hospitals. A predefined questionnaire was used to collect data including patient demographics, IBD history, opioid use in the past year (>2 weeks) and opioid-use mitigation techniques. Additionally, consecutive IBD-related hospital stays leading up to July 2019 were reviewed with data collected regarding opioid use at admission, discharge and follow-up as well as details of the admission indication. Results: In 1352 outpatients, 12% had used opioids within the past 12 months. Over half of these individuals were taking opioids for non-IBD pain and less than half had undergone an attempted opioid wean.In 324 hospitalised patients, 27% were prescribed opioids at discharge from hospital. At 12 months postdischarge, 11% were using opioids. Factors associated with opioid use in both cohorts included female sex, Crohn's disease and previous surgery. Conclusions: 1 in 10 patients with IBD attending outpatient appointments were opioid exposed in the past year while a quarter of inpatients were discharged with opioids, and 11% continued to use opioids 12 months after discharge. IBD services should aim to identify patients exposed to opioids, reduce exposure where possible and facilitate access to alternative pain management approaches.
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OBJECTIVES: To quantify the research contribution related to Ramadan fasting and diabetes. METHODS: We searched for the combination of "Ramadan" and Diabetes" in the title, abstract and keywords in the Scopus database between 1989 and 2018. Articles were analysed for standard bibliometric methodology and VOSviewer was used to construct bibliometric diagrams. RESULTS: The total number of retrieved articles was 424 articles; 112 were "Open Access". Two-thirds of articles covered original research. Articles were published in medical journals of varying influence. UK-based authors and affiliated institutions were dominant. A single author has an evident dedication to Ramadan research whereas for many authors it Ramadan research was just one aspect of their academic interest. The number publications and the extent of international collaborations were lower than expected, given the world-wide practice of Ramadan fasting by many populations with an increased prevalence of diabetes. The need to share experiences and generalizable conclusions. CONCLUSIONS: This is the first bibliometric study on diabetes in Ramadan. It is a good starting point to evaluate gaps in research activity in the field and should help identify future research directions and foster more collaboration.
