Table 3

Patient and practice characteristics for longitudinal step-up and step-down analyses

Stepping up to stronger opioidsStepping down from stronger opioids
Yes (%)No (%)Yes (%)No (%)
Number of patient years1 66247 4039375 795
Patient demography
Female 18–49 years255 (15.3)8174 (17.2)137 (14.6)879 (15.2)
Female 50–64 years317 (19.1)9642 (20.3)196 (20.9)1181 (20.4)
Female 65–100 years600 (36.1)13 235 (27.9)354 (37.8)1915 (33.0)
Male 18–49 years117 (7.0)3808 (8.0)45 (4.8)552 (9.5)
Male 50–64 years181 (10.9)5705 (12.0)92 (9.8)673 (11.6)
Male 65–100 years192 (11.6)6839 (14.2)113 (12.0)625 (10.8)
British1045 (62.9)24 776 (52.3)542 (57.8)3618 (62.4)
Pakistani119 (7.2)7885 (16.6)91 (9.7)389 (6.7)
Other157 (9.4)4687 (9.9)101 (10.8)515 (8.9)
Unknown341 (20.5)10 174 (21.5)203 (21.7)1273 (22.0)
Patient morbidity, behaviour and healthcare use
Mental health problem72 (4.3)1661 (3.5)35 (3.7)218 (3.8)
Definitively diagnosed disease493 (29.7)7493 (15.8)186 (19.8)1127 (19.4)
Clinical presentation without a definite diagnosis900 (54.2)18 366 (38.7)384 (41.0)2442 (42.1)
Pain-associated syndrome21 (1.3)341 (0.7)8 (0.8)55 (0.9)
Alcohol problem17 (1.0)1645 (3.5)4 (0.4)43 (0.7)
Smoking194 (11.7)5147 (10.8)94 (10.0)660 (11.4)
Body mass index
 Normal43 (4.8)1 192 (2.5)25 (2.7)166 (2.9)
 Overweight or obese118 (7.1)3166 (6.7)63 (6.7)360 (6.2)
 Underweight9 (0.5)85 (0.2)0 (0)18 (0.3)
 Unknown1 492 (90.0)42 960 (90.6)849 (90.6)5251 (90.6)
Number of repeat prescriptions
 None90 (5.4)7836 (16.5)98 (10.4)431 (7.4)
 1–4495 (29.8)19 609 (41.4)318 (3.4)1908 (33.0)
 5–9507 (30.5)11 492 (24.2)248 (2.6)1594 (27.5)
 10–56570 (34.3)8466 (17.8)273 (29.1)1862 (32.1)
Number of consultations
 0–6117 (7.0)11 122 (23.5)132 (1.3)800 (13.8)
 7–12298 (17.9)14 415 (30.4)224 (23.9)1270 (21.9)
 13–3661247 (75.0)21 866 (46.1)581 (62.0)3725 (64.3)
Number of missed appointments
 0903 (54.3)28 482 (60.0)543 (58.0)3302 (57.0)
 1–2564 (33.9)14 267 (30.1)297 (31.7)1793 (30.9)
 3–29195 (11.7)4654 (9.8)97 (10.4)700 (12.1)
Referrals
 Diagnostic testing164 (9.9)3384 (7.1)80 (8.5)491 (8.5)
 Medical specialty303 (18.2)5200 (11.0)141 (15.0)863 (14.9)
 Musculoskeletal specialty470 (28.3)6710 (14.2)198 (21.1)1100 (19.0)
 Neurology107 (6.4)1073 (2.3)22 (2.3)249 (4.3)
 Specialist pain management220 (13.2)919 (1.9)47 (5.0)494 (8.5)
 Surgical specialty186 (11.2)3051 (6.4)85 (9.1)513 (8.8)
Practice characteristics
List size
 1496–699921 563 (45.5)679 (40.8)2337 (40.3)427 (45.6)
 7000–11 00014 959 (31.6)563 (33.9)2021 (34.9)292 (31.2)
 11 000–25 11210 881 (23.0)420 (25.3)1437 (24.8)218 (23.2)
Practice Index of Multiple Deprivation
 6.7–26.612 507 (26.4)504 (30.3)1711 (29.5)267 (28.5)
 26.7–39.416 270 (34.2)669 (40.2)2480 (42.8)366 (39.1)
 39.5–6018 626 (39.3)489 (29.4)1604 (27.7)304 (32.4)
Number of GPs
 0–418 496 (39.0)566 (34.1)1938 (33.4)369 (39.4)
 5–920 316 (42.9)774 (46.6)2638 (45.5)416 (44.4)
 10–208591 (18.1)322 (19.4)1219 (21.0)152 (16.2)
 Teaching status18 803 (39.7)763 (45.9)2629 (45.4)371 (39.6)
Total QOF clinical domain points within each year
 404–65416 245 (34.3)482 (29.0)1550 (26.7)275 (29.4)
 655–67715 569 (32.8)544 (32.7)1914 (33.0)316 (33.7)
 678–69715 589 (32.9)636 (38.3)2331 (40.2)346 (36.9)
  • GP, general practitioner; QOF, Quality and Outcomes Framework.