Opioids – MO opportunities

Overview

At the end of July 2023 NHSE published guidance titled “National medicines optimisation opportunities 2023/24”. This guidance describes the 16 national medicines optimisation opportunities for the NHS in 2023/24, and signposts to resources to help with their implementation. It recommends Integrated Care Boards (ICBs) choose at least five medicines optimisation opportunities to focus and deliver on alongside their local medicines optimisation priorities. Progress against chosen opportunities will be reviewed using available data.

This report focuses on reducing opioid use in chronic non-cancer pain and has data at SICBL, ICB and Commissioning Region level.

NHS England Aim: Reduce the number of patients prescribed an opioid for use in chronic non-cancer pain and reduce the number of patients receiving an oral morphine equivalent of ≥120mg/day.

The report is provided to NHS colleagues only, please do not share outside the NHS.

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This publication is part of our Strategic Support and Planning contract. To gain access please email us at nuth.nyrdtc.rxsupp@nhs.net.   

Frequency

Quarterly

Data period

January 2021 to December 2023

Budget impact of paracetamol 250mg/5ml oral suspension

The purpose of this bulletin is to highlight the increase in cost of paracetamol 250mg/5ml oral suspensions since May 2022. It considers the potential savings that could be achieved through cost-effective paracetamol suspension prescribing across the ICSs in the North East & Yorkshire region and Greater Manchester.

Polypharmacy & Overprescribing: Opioid population health management

Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve. PPHs use prescribing data, biomedical literature and other data sources to provide new insights.

In recent years, there has been increasing concern regarding the overprescribing of opioids and associated harms. The RDTC has produced a series of publications as part of the Polypharmacy and Overprescribing theme reviewing opioid prescribing:

Each publication includes considerations and interventions for medicines optimisation teams and health systems. To avoid duplication across this series of overprescribing and polypharmacy opioid publications, the suggested actions have only been listed in the most relevant theme but may apply across all. We recommend reading all parts of the series sequentially to ensure the breadth of potential actions are known.

This is the third part of the series which focuses on the population health management of patients prescribed opioids, specifically in terms of deprivation level and the impact on sustainability and climate change.

Use the following links to access the first part in the series entitled ‘Opioid patient populations’ and the second in the series entitled ‘Opioid patient demographics’

This publication is part of our Strategic Support and Planning contract. To gain access please email us at nuth.nyrdtc.rxsupp@nhs.net.   

Polypharmacy & Overprescribing: Opioid patient demographics

Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve. PPHs use prescribing data, biomedical literature and other data sources to provide new insights.

In recent years, there has been increasing concern regarding the overprescribing of opioids and associated harms. The RDTC has produced a series of publications as part of the Polypharmacy and Overprescribing theme reviewing opioid prescribing:

Each publication includes considerations and interventions for medicines optimisation teams and health systems. To avoid duplication across this series of overprescribing and polypharmacy opioid publications, the suggested actions have only been listed in the most relevant theme but may apply across all. We recommend reading all parts of the series sequentially to ensure the breadth of potential actions are known.

This is the second part of the series which focuses on the demographics of the patient populations prescribed opioids.

Use the following link to access the first part in the series entitled ‘Opioid patient populations

This publication is part of our Strategic Support and Planning contract. To gain access please email us at nuth.nyrdtc.rxsupp@nhs.net.   

Polypharmacy & Overprescribing: Opioid patient populations

Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve. PPHs use prescribing data, biomedical literature and other data sources to provide new insights.

In recent years, there has been increasing concern regarding the overprescribing of opioids and associated harms. The RDTC has produced a series of publications as part of the Polypharmacy and Overprescribing theme reviewing opioid prescribing:

Each publication includes considerations and interventions for medicines optimisation teams and health systems. To avoid duplication across this series of overprescribing and polypharmacy opioid publications, the suggested actions have only been listed in the most relevant theme but may apply across all. We recommend reading all parts of the series sequentially to ensure the breadth of potential actions are known.

In this first part of the series, the focus is on the patient populations prescribed opioids and the inter-relationships and dependencies between prescribing and the available metrics.

This publication is part of our Strategic Support and Planning contract. To gain access please email us at nuth.nyrdtc.rxsupp@nhs.net.   

Pain Management

Overview

This report looks at prescribing trends in primary care in relation to Pain Management at ICB and Sub Integrated Board location (SICBl) with particular focus on Opioid and Non-opioid analgesics, Neuropathic pain, Antimigraine drugs and Osteoarthritis.

If you have any queries about the content of the report please contact us at nuth.nyrdtc.rxsupp@nhs.net

Frequency

Bi-annually

Data Period

October 2020 to September 2023

Formulary assessment – Morphine sulfate (Actimorph) orodispersible tablets

Formulary assessment tools are templates to support local decision making. They list NICE guidance, MHRA safety advice, and other relevant high quality advice and guidelines relevant to making decisions for local formularies.

The templates are pre-populated with useful information to reduce duplication of effort, with space for the addition of local information as appropriate. The purpose of the document is to support consistent decision making by formulary groups and APCs.

This information is produced for use by NHS healthcare professionals and RDTC stakeholders.

Safer Medication Use – Opioids and gabapentinoids

Overview

Safer Medication Use is a bulletin series jointly produced by the Regional Drug and Therapeutics Centre and the Yellow Card Centre Northern and Yorkshire, which aims to promote safer prescribing. It discusses specific drug related safety problems, provides guidance to ensure safe, appropriate prescribing and raises awareness of adverse drug reaction detection and reporting.

The use of combination opioids and gabapentinoids is associated with an increased risk of adverse events. Gabapentinoid overdose is much more likely to be fatal when combined with opioids and there is a greater risk of gabapentinoid dependence in patients with a history of opioid use disorder.

There are limited circumstances when patients should be prescribed both an opioid and a gabapentinoid, and prescribers must carefully balance potential benefits against the risk of adverse effects from combination therapy. In such situations the opioid dose should be reduced before starting a gabapentinoid and the patient reviewed regularly. Treatment should be stopped if it is not effective or not tolerated but withdrawal of established opioids and / or gabapentinoid therapy should be done slowly to prevent discontinuation symptoms.

Postoperative patients who are prescribed long term gabapentinoids should be closely monitored for respiratory depression.