The Medicines Safety Improvement Programme, as part of the Yorkshire and Humber Patient Safety Collaborative, focuses on reducing harm from opioids for non-cancer pain.
This is a massive issue impacting negatively on a lot of people’s lives across the region, with over 624 million doses of opioids prescribed in England in 2018-19, our input into this multifaceted subject has been welcomed by system leads, clinicians and other stakeholders as we add our patient safety expertise to this challenge. Some of the possible long term health consequences are serious and include increased risk of falls and fractures, depression, infertility, reduced immunity responses and heightened pain sensitivity.
There are multiple routes for people to be initially prescribed opioids e.g., in hospital following surgery, from their GPs in response to acute pain problems, or via pain services. Following this initial prescription when and how the treatment is reviewed and who was responsible for this happening is also complex.
Fortunately (for us) we were certainly not alone in recognising this issue and trying to do something about it. In our scoping we have found multiple examples of good practice and have already spoken to some inspirational people who are working in this field, for example using social prescribing methods, including the Keighley Healthy Living project which looks to develop a care pathway for people living with musculoskeletal condition and chronic pain.
There are also some very good data sources available via the ePACT2 system which allows healthcare colleagues to see quickly which of their patients are on higher dose opioids and how long they have been on them so Structure Medications Reviews can be targeted. We are lucky to have the evidence base provided via the CROP (Campaign to Reduce Opioid Prescribing) study in West Yorkshire to help us understand how data can be used effectively at practice level to make a difference.
This is a big issue to address and won’t happen quickly, reducing opioids involves partnership working between the clinician and patient and needs a lot of ongoing support from the clinical team, the patient’s family and friends and the wider community. Fortunately, there are a lot of good charities working in this field with some great freely available resources.
Over the remainder of the year, we will be collating these resources and examples of good practice, sharing them via our website and social media channels as well as linking with our colleagues who are leading the polypharmacy programmes across the region. We are also looking forward to working with our colleagues in West Yorkshire on some targeted interventions to help tackle this topic.
If you would like to share your work in reducing opioids harm or to join our medicines safety mailing list, please contact Nicola Chicken at Nicola.firstname.lastname@example.org