Article

Quantifying prescribed high dose opioids in the community and risk of overdose

Citation

Schofield J, Steven D, Foster R, Matheson C, Baldacchino A, McAuley A & Parkes T (2021) Quantifying prescribed high dose opioids in the community and risk of overdose. BMC Public Health, 21 (1), Art. No.: 1174. https://doi.org/10.1186/s12889-021-11162-4

Abstract
Background Opioid prescribing for a range of health issues is increasing globally. The risk of fatal and non-fatal overdose is increased among people prescribed strong opioids: in high doses in the context of polypharmacy (the use of multiple medications at the same time), especially with other sedatives; and among people with multiple morbidities including cardiorespiratory, hepatic and renal conditions. This study described and quantified the prescribing of strong opioids, comorbidities and other overdose risk factors among those prescribed strong opioids, and factors associated with high/very high opioid dosage in a regional health authority in Scotland as part of a wider service improvement exercise. Methods Participating practices ran searches to identify patients prescribed strong opioids and their characteristics, polypharmacy, and other overdose risk factors. Data were anonymised before being analysed at practice and patient-level. Morphine Equivalent Doses were calculated for patients based on drug/dose information and classed as Low/Medium/High/Very High. Descriptive statistics were generated on the strong opioid patient population and overdose risk factors. The relationship between the prescribing of strong opioids and practice/patient-level factors was investigated using linear and logistic regression models. Results Eighty-five percent (46/54) of GP practices participated. 12.4% (42,382/341,240) of individuals in participating practices were prescribed opioids and, of these, one third (14,079/42,382) were prescribed strong opioids. The most common comorbidities and overdose risk factors among strong opioid recipients were pain (67.2%), cardiovascular disease (43.2%), and mental health problems (39.3%). There was a positive significant relationship between level of social deprivation among practice caseload and level of strong opioid prescribing (p 

Keywords
Prescription opioids; Overdose; Analgesics; Comorbidities; General practice; Polypharmacy

Journal
BMC Public Health: Volume 21, Issue 1

StatusPublished
FundersNHS Fife
Publication date31/12/2021
Publication date online24/06/2021
Date accepted by journal26/05/2021
URLhttp://hdl.handle.net/1893/32827
PublisherSpringer Science and Business Media LLC
eISSN1471-2458

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