Digitally deployed, GP remote consultation video intervention that aims to reduce opioid prescribing in primary care: protocol for a mixed-methods evaluation.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
06 02 2023
Historique:
entrez: 6 2 2023
pubmed: 7 2 2023
medline: 9 2 2023
Statut: epublish

Résumé

Opioid prescribing rates are disproportionately high in the North of England. In addition to patients' complex health needs, clinician prescribing behaviour is also a key driver. Although strategies have been initiated to reduce opioid prescribing nationally, the COVID-19 pandemic has interrupted service provision and created challenges for the system and health professionals to tackle this complex issue. A pilot intervention using smartphone video messaging has been developed to remotely explain the rationale for opioid reduction and facilitate self-initiation of support. The aim of this study is to evaluate the potential benefits, risks and economic consequences of 'at scale' implementation. This will be a mixed-methods study comprising a quasi-experimental non-randomised before-and-after study and qualitative interviews. The intervention arm will comprise 50 General Practitioner (GP) Practices using System 1 (a clinical computer system hosting the intervention) who will deliver the video to their patients via text message. The control arm will comprise 50 practices using EMIS (a different computer system) who will continue usual care. Monthly practice level prescribing and consultation data will be observed for 6 months postintervention. A general linear model will be used to estimate the association between the exposure and the main outcome (opioid prescribing; average daily quantity (ADQ)/1000 specific therapeutic group age-sex related prescribing unit). Semi-structured interviews will be undertaken remotely with purposively selected participants including patients who received the video, and health professionals involved in sending out the videos and providing additional support. Interviews will be audio recorded, transcribed and analysed thematically. Ethics approval has been granted by the NHS Health Research Authority Research Ethics Committee (22/PR/0296). Findings will be disseminated to the participating sites, participants, and commissioners, and in peer-reviewed journals and academic conferences. NCT05276089.

Identifiants

pubmed: 36746541
pii: bmjopen-2022-066158
doi: 10.1136/bmjopen-2022-066158
pmc: PMC9906169
doi:

Substances chimiques

Analgesics, Opioid 0

Banques de données

ClinicalTrials.gov
['NCT05276089']

Types de publication

Clinical Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e066158

Informations de copyright

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: BA has developed the video intervention. The video may be commercialised for financial gain.

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Auteurs

Yu Fu (Y)

Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK yu.fu@newcastle.ac.uk.
Applied Research Collaboration North East and North Cumbria, NIHR, Gosforth, UK.

Ben Allen (B)

Birley Health Centre, Sheffield, UK.

Alan M Batterham (AM)

Centre for Rehabilitation, Teesside University, Middlesbrough, UK.

Christopher Price (C)

Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.
Applied Research Collaboration North East and North Cumbria, NIHR, Gosforth, UK.
Northumbria Healthcare NHS Foundation Trust, Ashington, UK.

Niki Jones (N)

Centre for Rehabilitation, Teesside University, Middlesbrough, UK.

Denis Martin (D)

Applied Research Collaboration North East and North Cumbria, NIHR, Gosforth, UK.
Health and Social Care Institute, Teesside University, Middlesbrough, UK.

Nick Hex (N)

York Health Economics Consortium Ltd, University of York, York, UK.

Ewan Maule (E)

North East and North Cumbria Integrated Care Board, North East and North Cumbria Integrated Care System, Sunderland, UK.

Tracy Finch (T)

Applied Research Collaboration North East and North Cumbria, NIHR, Gosforth, UK.
Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK.

Julia L Newton (JL)

Academic Health Science Network for the North East and North Cumbria, Newcastle upon Tyne, UK.

Cormac G Ryan (CG)

Centre for Rehabilitation, Teesside University, Middlesbrough, UK.

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