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7 Mar 2022

Evaluating the impact of a new intervention to reduce opioid prescribing in primary care


This new joint project will evaluate the impact of an evidence informed, digitally deployed, GP remote consultation video intervention that aims to reduce opioid prescribing in primary care.

The NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC) and Academic Health Science Network  (AHSN) NENC have been awarded £275,000 funding by the NHS Insights Prioritisation Programme (NIPP) for a rapid evaluation of COVID-19 related responses – which includes this project.

The project aims to evaluate the potential benefits, risks, and costs of an evidence informed, digitally deployed, GP remote consultation video intervention that aims to reduce opioid prescribing in primary care. This digital remote intervention will be embedded into existing opiate reduction measures across the NENC Integrated Care System.

Opioid prescribing rates in the NENC are a third higher than the second highest prescribing Integrated Care System. The top seven opioid prescribing CCGs are all in NENC and demonstrated a strong association with deprivation.

Opioid prescribing in our region is also higher than the national average for areas with similar deprivation and 3.3 times higher than the most deprived areas in London, indicating the importance of other factors such as clinician behaviour and access to support services.

Opioid drugs alone cost the UK £10.7 billion annually in policing, healthcare and crime, with drug-related theft alone costing £6 billion a year. This joint project therefore has the potential to change practice as well as potentially impact on the high societal costs.

During the pandemic, a novel process was developed by a GP in Yorkshire to remotely explain reasons for opioid reduction and initiate support, targeted at patients identified as prescribed high levels of medication. A short video suitable for smartphone viewing is messaged using a two-way communication system. Patients can watch the video more than once, and request additional support by replying with a simple text or email response.

This enables efficient delivery of a discrete offer of help to at risk individuals who often avoid service contact. The intervention was well received by patients, saved significant clinical time, and promised to be effective in reducing opioid consumption in a pilot evaluation.

Led by Professors Julia Newton (Medical Director, AHSN) and Cormac Ryan (Professor of Clinical Rehabilitation, Teesside University) and supported by Ewan Maule (ICS Chief Pharmacist), researchers will use anonymous patient records and interviews, in collaboration with patients with lived experience, to find out how effective the remote consultation video intervention is in primary care.

Dr Maggie Fu, ARC NENC Research Fellow with the Enabling Methodologies theme, will lead work on behalf of the ARC NENC.

As well as evidence and rapid insights to inform the accelerated implementation of the intervention within the ICS, the work will provide evidence that will underpin the future adoption of the intervention into wide scale clinical management and that can be disseminated as a future national programme via the AHSN Network.

This project runs from January 2022 to June 2023.