Researchers recommend greater action to promote best practice as a new study reveals a rise in prescriptions of opioids for treating chronic pain rise between 1998 and 2018.
A review of opioid prescribing in the UK has shown that UK doctors are prescribing more and stronger opioid drugs to patients. The research showed a 34% rise between 1998 and 2016, which when corrected for total oral morphine equivalency increased to 127%. However, the study also showed a decline in prescriptions between 2016 and 2017.
The research also showed a wide variation in opioid prescribing across the country, with the highest prescribers in northern and coastal areas and the lowest in Greater London. Larger practice list size, ruralness and deprivation are all also associated with greater high-dose prescribing rates.
Ben Goldacre, Senior Clinical Research Fellow from Oxford University’s Nuffield Department of Primary Care Health Sciences, who led the study, said: ‘The US is in the middle of an opioid crisis. UK use has not yet matched that scale, but our work shows that close monitoring is needed.
‘This is why we have shared all our tools on OpenPrescribing.net. Our website is open to all, allowing clinicians and others to see what individual practices and regions are prescribing. High prescribers are not necessarily bad prescribers: they may, for example, specialise in treating substance misuse. But thoughtful data monitoring is key, to ensure problems are not missed.
‘Taking greater action to promote best practice, such as prescribing lower doses for a shorter duration, could also save substantial NHS resources. If every practice changed their prescribing of high-dose opioids to match practices at the lowest 10%, this could save 543,000 high-dose prescriptions over six months.’
The study - based on all prescribing data in the NHS from 1998-2018 - is the largest and most comprehensive opioid trends study to date, and is accompanied by a live tool for anyone to check the latest info on their practice or CCG: https://openprescribing.net/measure/?tags=opioids
The study and tool were created by the DataLab at the University of Oxford, which is headed by Dr Ben Goldacre. The DataLab is a multidisciplinary team of clinicians, academics and software engineers: they build interactive data-driven tools for the NHS and academia, as well as pure academic papers.
The full paper, ‘Opioid Prescribing Trends and Geographical Variation in England 1998-2018 – A Retrospective Database Study,’ can be read in The Lancet Psychiatry.
The study is funded by the National Institute for Health Research and NHS England.