Bedson, J, Belcher, J, Martino, OI, Ndlovu, M, Rathod, T, Walters, K, Dunn, KM ORCID: https://orcid.org/0000-0002-6202-2606 and Jordan, KP (2013) The effectiveness of national guidance in changing analgesic prescribing in primary care from 2002 to 2009: an observational database study. European Journal of Pain, 17 (3). 434 -443.

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Abstract

BACKGROUND: Numerous national guidelines have been issued to assist general practitioners' safe analgesic prescribing. Their effectiveness is unclear. The objective of this study was to examine trends in general practitioners' prescribing behaviour in relation to national guidelines. METHODS: This was a retrospective observational database study of registered adult patients prescribed an analgesic (2002-2009) from the Consultations in Primary Care Archive--12 North Staffordshire general practices. Prescribing guidance from the UK Medicines Regulatory Health Authority (MHRA) regarding non-steroidal anti-inflammatory drugs (NSAIDs) and co-proxamol, and the National Institute for Health and Clinical Excellence (NICE) osteoarthritis (OA) management guidelines were considered. Analgesic prescribing rates were examined, arranged according to a classification of six equipotent medication groups: (1) basic analgesics; (2)-(5) increasingly potent opioids and (6) NSAIDs. In each quarter from 2002 to 2009, the number of patients per 10,000 registered population receiving a prescription for the first time from each group was determined. Quarters associated with significant changes in the underlying prescribing trend were determined using joinpoint regression. RESULTS: A significant decrease in incident co-proxamol and Cox-2 prescribing occurred around the time of the first MHRA advice to stop using them and were rarely prescribed thereafter. The new prescribing of weak analgesics (e.g., co-codamol 8/500) increased at this same time. Initiating topical NSAIDs significantly increased around the time of the NICE OA guidelines. CONCLUSIONS: Significant prescribing changes occurred when national advice and guidelines were issued. The effectiveness of this advice may vary depending upon the content and method of dissemination. Further evaluation of the optimal methods for delivering prescribing guidance is required.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Wiley at https://doi.org/10.1002/j.1532-2149.2012.00189.x - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Acetaminophen, Administration, Topical, Adolescent, Adult, Aged, Analgesics, Analgesics, Opioid, Anti-Inflammatory Agents, Non-Steroidal, Cyclooxygenase 2 Inhibitors, Databases, Factual, Dextropropoxyphene, Drug Combinations, Drug Prescriptions, Drug Utilization, Female, General Practitioners, Guideline Adherence, Guidelines as Topic, Humans, Male, Middle Aged, Pain, Primary Health Care, United Kingdom, Young Adult
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
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Depositing User: Symplectic
Date Deposited: 13 Dec 2019 16:16
Last Modified: 13 Dec 2019 16:17
URI: https://eprints.keele.ac.uk/id/eprint/7380

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