Difficulties with prescribed opioids: a cross-sectional survey of primary care patients in England, United Kingdom.

INTRODUCTION

Knowledge of the potential for harm and adverse effects from long-term opioid medicines has led to reduced prescribing in recent years. However, the number of patients receiving opioid prescriptions from primary care in England remains substantial and understanding the difficulties patients experience with these medicines is important for the provision of care.

OBJECTIVE

To understand the difficulties experienced by patients prescribed opioids for noncancer pain in primary care.

METHODS

A cross-sectional postal survey of adults prescribed an opioid medicine for noncancer pain over a period of ≥3 months from 10 general practices (n = 3077) in the East Midlands was conducted using self-completed questionnaires. Sociodemographic, pain, and opioid use information was gathered to characterise the study population. An adapted version of the 15-item Prescribed Opioids Difficulties Scale was used to assess the problems and concerns attributed to using prescribed opioids, from the time opioids were first prescribed.

RESULTS

Questionnaires were received from 619 respondents (response rate = 20.1%), of whom 59.8% were female, and the median age was 64 years. Four in 5 (79.8%) had experienced at least one opioid problem or concern from the Prescribed Opioids Difficulties Scale, and one in 5 (22.8%) had experienced 8 or more. The most frequently reported difficulty was needing to increase the dose of opioids to get the same effect (46.0%). Chi-square analysis with odds ratio found respondents were 2.6 times more likely to report ≥4 difficulties if they had higher pain intensity and interference (95% CI: 1.85-3.77, < 0.001).

CONCLUSION

Opioid difficulties were common in this population and this study provides evidence for regular monitoring of problems after prescribing.