New prescribing comparators available to help reduce harm in opioid prescribing

Some prescription medicines can be addictive and could cause problems for people taking them or coming off them, especially if someone has been taking them for a long time.

The NHS Business Services Authority (NHSBSA) Opioid Prescribing Comparators will help GPs and pharmacists understand how many patients are taking these medicines and to identify those most in need of support to improve the way their pain is managed.  

Patients taking any of the medicines highlighted in the tool as prescribed by their doctor should not stop taking them on their own but should take guidance from their doctor.

The opioid prescribing comparators have been developed in partnership between NHS Business Services Authority, Wessex Academic Health Science Network (AHSN) and NHS England. Clinicians, data analysts and statisticians came together to develop comparators to support local work to reduce harm from opioid prescribing for non-cancer pain.  

The NHSBSA Opioid Prescribing Comparators will help GPs and others to understand the scale of their local opioid prescribing issues; see which areas of opioid prescribing are most problematic locally; and to identify patients who are at greatest risk from harm to be prioritised for a structured medication review. They will also help measure the impact of any interventions aimed at reducing harm from opioids.

This is the first national prescribing data to split prescribing data by gender. They are also the first to make live electronic prescribing system (EPS) data available to help identify patients who have been on opioids for three but not yet six months, to help prevent acute use of opioids turning into chronic use for non-cancer pain.

The comparators are part of the programme of work in response to the Public Health England (PHE) 2019 Prescribed Medicines Review. It is planned to add more views, comparators and datasets in due course.

In the report, analysis showed that in 2017-2018, 11.5 million adults in England (26% of the adult population) had received one or more prescriptions for antidepressants, opioid pain medicines, gabapentinoids, benzodiazepines or z-drugs.

It also showed that 5.6 million people (13% of the population) had received a prescription for an opioid pain medicine. In the most recent financial year 2020-2021, opioid prescribing has decreased by approximately 11%, since PHE reporting in 2017/18.

The NHS national Medicines Safety Improvement Programme is currently developing new resources to help local health systems to tackle inappropriate use of opioids in their communities, as one of a number of actions to optimise the use of medicines across England.

The data is extracted from prescription data and does not contain diagnosis. Therefore, when using the data to prioritise patients, practices will need to screen out patients using opioids for cancer pain as this is an entirely clinically appropriate usage of opioids.

The NHSBSA Opioid Prescribing Comparators are available to all GP practices, Primary Care Networks, ICSs and AHSNs in England via ePACT2. To register for ePACT2 see https://www.nhsbsa.nhs.uk/access-our-data-products/epact2/registering-epact2 

This is the first iteration of the NHSBSA Opioid Prescribing Comparators. Further developments in functionality are planned and will be released in the near future.