Opioid prescribing in general practice: an Australian cross-sectional survey.


Journal

BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676

Informations de publication

Date de publication:
08 07 2022
Historique:
received: 26 02 2022
accepted: 20 06 2022
entrez: 8 7 2022
pubmed: 9 7 2022
medline: 14 7 2022
Statut: epublish

Résumé

Prescribed opioid doses > 100 mg oral morphine equivalent (OME) and/or co-prescribing of sedating psychoactive medications increase the risk of unintentional fatal overdose. We describe general practice encounters where opioids are prescribed and examine high-risk opioid prescribing. The 2006-2016 BEACH study data, a rolling national cross-sectional survey of randomly selected GPs, was analysed. Opioid prescribing increased 2006-2007 to 2015-2016, however, this plateaued across the latter half-decade. From 2012-2016 3,897 GPs recorded 389,700 encounters and at least one opioid was prescribed at 5.2%. Opioid encounters more likely involved males, those 45-64 years, concession card holders and the socioeconomically disadvantaged. GPs more likely to prescribe opioids were 55 years or older, male, Australian graduates, and in regional and remote areas. The most common problems managed with opioids involved chronic non-cancer pain. One-in-ten opioid prescribing episodes involved high-risk doses and 11% involved co-prescription of sedating psychoactive medications. Over one-third of GPs provided other (non-pharmacological) interventions at encounters with opioid prescriptions. Only 5% of GP encounters involved an opioid prescription. Of concern, were: prescribing for chronic non-cancer pain, potentially high-risk opioid encounters where > 100 OME daily dose was prescribed, and/or there was co-prescription of sedating psychoactive medication. However, approximately one-in-three opioid prescribing encounters involved non-pharmacological interventions.

Sections du résumé

BACKGROUND
Prescribed opioid doses > 100 mg oral morphine equivalent (OME) and/or co-prescribing of sedating psychoactive medications increase the risk of unintentional fatal overdose. We describe general practice encounters where opioids are prescribed and examine high-risk opioid prescribing.
METHODS
The 2006-2016 BEACH study data, a rolling national cross-sectional survey of randomly selected GPs, was analysed.
RESULTS
Opioid prescribing increased 2006-2007 to 2015-2016, however, this plateaued across the latter half-decade. From 2012-2016 3,897 GPs recorded 389,700 encounters and at least one opioid was prescribed at 5.2%. Opioid encounters more likely involved males, those 45-64 years, concession card holders and the socioeconomically disadvantaged. GPs more likely to prescribe opioids were 55 years or older, male, Australian graduates, and in regional and remote areas. The most common problems managed with opioids involved chronic non-cancer pain. One-in-ten opioid prescribing episodes involved high-risk doses and 11% involved co-prescription of sedating psychoactive medications. Over one-third of GPs provided other (non-pharmacological) interventions at encounters with opioid prescriptions.
CONCLUSIONS
Only 5% of GP encounters involved an opioid prescription. Of concern, were: prescribing for chronic non-cancer pain, potentially high-risk opioid encounters where > 100 OME daily dose was prescribed, and/or there was co-prescription of sedating psychoactive medication. However, approximately one-in-three opioid prescribing encounters involved non-pharmacological interventions.

Identifiants

pubmed: 35804306
doi: 10.1186/s12875-022-01783-y
pii: 10.1186/s12875-022-01783-y
pmc: PMC9264661
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

171

Informations de copyright

© 2022. The Author(s).

Références

Intern Med J. 2009 Oct;39(10):676-81
pubmed: 19460051
Med J Aust. 2012 Apr 2;196(6):380-1
pubmed: 22471532
Inj Prev. 2011 Aug;17(4):254-9
pubmed: 21164159
Addiction. 2022 Mar;117(3):677-686
pubmed: 34490926
Milbank Q. 2021 Dec;99(4):1024-1058
pubmed: 34402553
Aust J Public Health. 1995 Feb;19(1):34-40
pubmed: 7734591
Drug Alcohol Depend. 2017 Oct 1;179:291-298
pubmed: 28826104
EClinicalMedicine. 2021 Nov 13;42:101198
pubmed: 34820610
Pain Med. 2018 Jun 1;19(6):1170-1183
pubmed: 28402570
Intern Med J. 2016 Aug;46(8):955-63
pubmed: 26602489
Pain Med. 2015 Sep;16(9):1745-58
pubmed: 26011277
Drug Alcohol Depend. 2016 May 1;162:79-87
pubmed: 27049582
CNS Drugs. 2018 Feb;32(2):101-116
pubmed: 29498021
Pain. 2015 Feb;156(2):231-242
pubmed: 25599444
Br J Clin Pharmacol. 2016 Jul;82(1):255-67
pubmed: 26991673
J Vasc Surg. 2002 Jul;36(1):194-5
pubmed: 12096281
Forensic Sci Med Pathol. 2015 Mar;11(1):3-12
pubmed: 25403552
Aust Fam Physician. 2016 Dec;45(12):862-866
pubmed: 27903034
Br J Clin Pharmacol. 2018 Jun;84(6):1267-1278
pubmed: 29451672
Pain Med. 2013 Sep;14(9):1346-61
pubmed: 23855874

Auteurs

Sharon Reid (S)

Speciality of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia. sharon.reid@sydney.edu.au.
Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, 2050, Australia. sharon.reid@sydney.edu.au.
Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, NSW, 2050, Australia. sharon.reid@sydney.edu.au.

Carolyn Day (C)

Speciality of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.
Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, NSW, 2050, Australia.
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.

Natalie White (N)

Speciality of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.

Christopher Harrison (C)

Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.

Paul Haber (P)

Speciality of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.
Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, 2050, Australia.
Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, NSW, 2050, Australia.

Clare Bayram (C)

Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.

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