Patient and practice characteristics for cross-sectional analysis of associations with long-term and stronger opioid prescribing
| Four or more opioids prescriptions within year (long term) | Strength of opioid prescribed at any point within year | |||
|---|---|---|---|---|
| No (%) | Yes (%) | Weaker only (%) | Stronger (%) | |
| Number of patients | 62 339 | 37 508 | 93 242 | 6 605 |
| Patient demography | ||||
| Female 18–49 yreas | 19 455 (31.2) | 5636 (15.0) | 24 113 (25.9) | 978 (14.8) |
| Female 50–64 years | 8470 (13.6) | 6802 (18.1) | 14 239 (15.3) | 1033 (15.6) |
| Female 65–100 years | 9189 (14.7) | 11 225 (29.9) | 18 188 (19.5) | 2226 (33.7) |
| Male 18–49 years | 12 373 (19.8) | 3549 (9.5) | 15 104 (16.2) | 818 (12.4) |
| Male 50–64 years | 6561 (10.5) | 4627 (12.3) | 10 514 (11.3) | 674 (10.2) |
| Male 65–100 years | 6288 (10.1) | 5669 (15.1) | 11 081 (11.9) | 876 (13.3) |
| Missing gender | 3 (0) | 3 (0) | ||
| Ethnicity | ||||
| British | 31 877 (51.1) | 23 273 (62.0) | 51 021 (54.7) | 4129 (62.5) |
| Pakistani | 8525 (13.7) | 2939 (7.8) | 11 226 (12.0) | 238 (3.6) |
| Other | 7718 (12.4) | 3084 (8.2) | 10 329 (11.1) | 473 (7.2) |
| Unknown | 14 219 (22.8) | 8212 (21.9) | 20 666 (22.2) | 1765 (26.7) |
| Patient morbidity, behaviour and healthcare use | ||||
| Mental health problem | 1626 (2.6) | 1156 (3.1) | 2546 (2.7) | 236 (3.6) |
| Definitively diagnosed disease | 7359 (11.8) | 6170 (16.4) | 12 346 (13.2) | 1183 (17.9) |
| Clinical presentation without a definite diagnosis | 23 112 (37.1) | 12 714 (33.9) | 33 471 (35.9) | 2355 (35.6) |
| Pain-associated syndrome | 310 (0.5) | 205 (0.5) | 466 (0.5) | 49 (0.7) |
| Alcohol problem | 672 (1.1) | 475 (1.3) | 1055 (1.1) | 92 (1.4) |
| Smoking | 13 474 (21.6) | 7173 (19.1) | 19 422 (20.8) | 1225 (18.5) |
| Body mass index | ||||
| Overweight or obese | 6573 (10.5) | 3972 (10.6) | 9972 (10.7) | 573 (8.7) |
| Normal weight | 3232 (5.2) | 1510 (4.0) | 4484 (4.8) | 268 (4.0) |
| Underweight | 251 (0.4) | 149 (0.4) | 357 (0.4) | 43 (0.6) |
| Unknown | 52 273 (83.8) | 31 877 (85.0) | 78 429 (84.1) | 5721 (86.6) |
| Number of repeat prescriptions | ||||
| 0 | 15 066 (30.2) | 4375 (11.9) | 18 999 (23.6) | 442 (7.3) |
| 1–4 | 22 567 (45.2) | 14 450 (39.4) | 35 023 (43.5) | 1994 (32.8) |
| 5–9 | 8152 (16.3) | 9759 (26.6) | 16 280 (20.2) | 1631 (26.9) |
| 10–56 | 4150 (8.3) | 8054 (22.0) | 10 201 (12.7) | 2003 (33.0) |
| Unknown | 12 404 (19.9) | 870 (2.3) | 12 739 (13.7) | 535 (8.1) |
| Number of consultations | ||||
| 0–6 | 21 530 (35.2) | 8350 (22.8) | 29 035 (31.7) | 845 (14.0) |
| 7–12 | 19 810 (32.4) | 10 647 (29.0) | 29 174 (31.8) | 1283 (21.2) |
| 13–366 | 19 689 (32.3) | 17 677 (48.2) | 33 451 (36.5) | 3915 (64.8) |
| Unknown | 1310 (2.1) | 834 (2.2) | 1582 (1.7) | 562 (8.5) |
| Number of missed appointments | ||||
| 0 | 39 295 (63.0) | 22 556 (60.1) | 58 532 (62.7) | 3319 (50.2) |
| 1–2 | 17 197 (27.6) | 10 756 (28.7) | 26 061 (28.0) | 1892 (28.6) |
| 3–29 | 4537 (7.3) | 3362 (9.0) | 7067 (7.6) | 832 (12.6) |
| Unknown | 1310 (2.1) | 834 (2.2) | 1582 (1.7) | 562 (8.5) |
| Referrals | ||||
| Diagnostic testing | 6207 (10.0) | 4368 (11.6) | 9794 (10.5) | 781 (11.8) |
| Medical specialty | 5446 (8.7) | 4317 (11.5) | 8856 (9.5) | 907 (13.7) |
| Musculoskeletal specialty | 9370 (15.0) | 6926 (18.5) | 15 009 (16.1) | 1287 (19.5) |
| Neurology | 1126 (1.8) | 1046 (2.8) | 1890 (2.0) | 282 (4.3) |
| Specialist pain management | 460 (0.7) | 1135 (3.0) | 1070 (1.1) | 525 (7.9) |
| Surgical specialty | 3824 (6.1) | 2598 (6.9) | 5877 (6.3) | 545 (8.2) |
| Practice characteristics | ||||
| List size | ||||
| 1500–6999 | 22 869 (36.7) | 12 461 (33.2) | 33 133 (35.5) | 2197 (33.3) |
| 7000–10 999 | 20 127 (32.3) | 12 884 (34.4) | 30 855 (33.1) | 2156 (32.6) |
| 11 000–25 112 | 19 343 (31.0) | 12 163 (32.4) | 29 254 (31.4) | 2252 (34.1) |
| Practice Index of Multiple Deprivation | ||||
| 7–26.7 | 21 518 (34.5) | 13 248 (35.3) | 32 251 (34.6) | 2515 (38.1) |
| 26.7–39.5 | 20 029 (32.1) | 12 506 (33.3) | 30 129 (32.3) | 2406 (36.4) |
| 39.5–57.5 | 20 792 (33.4) | 11 754 (31.3) | 30 862 (33.1) | 1684 (25.5) |
| Number of GPs | ||||
| 0–4 | 25 852 (41.5) | 14 305 (38.1) | 37 645 (40.4) | 2512 (38.0) |
| 5–9 | 18 129 (29.1) | 11 607 (30.9) | 27 757 (29.8) | 1979 (30.0) |
| 9–20 | 18 358 (29.4) | 11 596 (30.9) | 27 840 (29.8) | 2114 (32.0) |
| Proportion of salaried GPs | ||||
| 0–16.7% | 20 779 (33.3) | 12 422 (33.1) | 30 807 (33.0) | 2394 (36.2) |
| 16.7–40% | 23 030 (36.9) | 14 097 (37.6) | 34 759 (37.3) | 2368 (35.8) |
| 40% and over | 18 172 (29.2) | 10 878 (29.0) | 27 222 (29.2) | 1828 (27.7) |
| Unknown | 358 (0.6) | 111 (0.3) | 454 (0.5) | 15 (0.2) |
| Patients per GP | ||||
| 707–1278 | 21 638 (34.7) | 13 670 (36.4) | 33 052 (35.4) | 2256 (34.2) |
| 1279–1558 | 19 744 (31.7) | 12 603 (33.6) | 29 847 (32.0) | 2500 (37.8) |
| 1559–4447 | 20 599 (33.0) | 11 124 (29.6) | 29 889 (32.0) | 1834 (27.8) |
| Unknown | 358 (0.6) | 111 (0.3) | 454 (0.5) | 15 (0.2) |
| Proportion of ‘first five’ GPs | ||||
| 0 | 34 016 (54.6) | 20 291 (54.1) | 50 462 (54.1) | 3845 (58.2) |
| 10–27.3% | 10 762 (17.3) | 6705 (17.9) | 16 407 (17.6) | 1060 (16.0) |
| 27.3–66.7% | 17 203 (27.6) | 10 401 (27.7) | 25 919 (27.8) | 1685 (25.5) |
| Unknown | 358 (0.6) | 111 (0.3) | 454 (0.5) | 15 (0.2) |
| Teaching status | 26 323 (42.2) | 16 118 (43.0) | 39 319 (42.2) | 3122 (47.3) |
| Total QOF clinical domain points | ||||
| 243–647 | 21 583 (34.6) | 12 859 (34.3) | 32 281 (34.6) | 2161 (32.7) |
| 648–657 | 21 630 (34.7) | 13 052 (34.8) | 32 330 (34.7) | 2352 (35.6) |
| 658–661 | 19 126 (30.7) | 11 597 (30.9) | 28 631 (30.7) | 2092 (31.7) |
GP, general practitioner; QOF, Quality and Outcomes Framework.