Show simple item record

dc.contributor.authorFoy, R.
dc.contributor.authorLeaman, B.
dc.contributor.authorMcCrorie, C.
dc.contributor.authorPetty, Duncan R.
dc.contributor.authorHouse, A.
dc.contributor.authorBennett, M.
dc.contributor.authorCarder, P.
dc.contributor.authorFaulkner, S.
dc.contributor.authorGlidewell, L.
dc.contributor.authorWest, R.
dc.date.accessioned2019-11-12T09:33:40Z
dc.date.accessioned2019-11-27T14:23:09Z
dc.date.available2019-11-12T09:33:40Z
dc.date.available2019-11-27T14:23:09Z
dc.date.issued2016-05
dc.identifier.citationFoy R, Leaman B, McCrorie C et al (2016) Prescribed opioids in primary care: cross-sectional and longitudinal analyses of influence of patient and practice characteristics. BMJ Open. 6(5): e010276.en_US
dc.identifier.urihttp://hdl.handle.net/10454/17516
dc.descriptionYesen_US
dc.description.abstractObjectives: To examine trends in opioid prescribing in primary care, identify patient and general practice characteristics associated with long-term and stronger opioid prescribing, and identify associations with changes in opioid prescribing. Design: Trend, cross-sectional and longitudinal analyses of routinely recorded patient data. Setting: 111 primary care practices in Leeds and Bradford, UK. Participants: We observed 471 828 patient-years in which all patients represented had at least 1 opioid prescription between April 2005 and March 2012. A cross-sectional analysis included 99 847 patients prescribed opioids between April 2011 and March 2012. A longitudinal analysis included 49 065 patient-years between April 2008 and March 2012. We excluded patients with cancer or treated for substance misuse. Main outcome measures: Long-term opioid prescribing (4 or more prescriptions within 12 months), stronger opioid prescribing and stepping up to or down from stronger opioids. Results: Opioid prescribing in the adult population almost doubled for weaker opioids over 2005–2012 and rose over sixfold for stronger opioids. There was marked variation among general practices in the odds of patients stepping up to stronger opioids compared with those not stepping up (range 0.31–3.36), unexplained by practice-level variables. Stepping up to stronger opioids was most strongly associated with being underweight (adjusted OR 3.26, 1.49 to 7.17), increasing polypharmacy (4.15, 3.26 to 5.29 for 10 or more repeat prescriptions), increasing numbers of primary care appointments (3.04, 2.48 to 3.73 for over 12 appointments in the year) and referrals to specialist pain services (5.17, 4.37 to 6.12). Compared with women under 50 years, men under 50 were less likely to step down once prescribed stronger opioids (0.53, 0.37 to 0.75). Conclusions: While clinicians should be alert to patients at risk of escalated opioid prescribing, much prescribing variation may be attributable to clinical behaviour. Effective strategies targeting clinicians and patients are needed to curb rising prescribing, especially of stronger opioids.en_US
dc.description.sponsorshipe National Institute for Health Research (NIHR) under its Research for Patient Benefit Programme (Grant Reference Number PB-PG- 1010-23041).en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1136/bmjopen-2015-010276en_US
dc.rightsPublished by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/en_US
dc.subjectOpioid prescribingen_US
dc.subjectPrimary careen_US
dc.subjectPatient characteristicssen_US
dc.subjectGeneral practice characteristicsen_US
dc.subjectCross-sectional and longitudinal analysesen_US
dc.titlePrescribed opioids in primary care: cross-sectional and longitudinal analyses of influence of patient and practice characteristicsen_US
dc.status.refereedYesen_US
dc.date.Accepted2016-03-21
dc.date.application2016-03-13
dc.typeArticleen_US
dc.type.versionPublished versionen_US
dc.date.updated2019-11-12T09:33:42Z
refterms.dateFOA2019-11-27T14:23:44Z


Item file(s)

Thumbnail
Name:
foyBMJopen.pdf
Size:
1.236Mb
Format:
PDF
Description:
Petty_BMJ_Open

This item appears in the following Collection(s)

Show simple item record