Improving the management of non cancer pain – reducing harm from opioids

Repeat prescribing of opioid medication is general practice is common.  Requests for opioids are received into general practice alongside the 100s of other medication requests received by each general practice per day.  Having a robust and effective process helps to ensure that these high-risk medicines are managed safely.  We have taken a Human Factors approach to understanding the prescribing process and to creating some minimum standards for practices in an ICD (in collaboration with Joined Up Care Derbyshire ICS).

What we've done so far 

• A Human Factors study to understand the barriers and facilitators to a safe opioid prescribing process in GP practice. (By HIEM Head of Medicines Safety Programme Delivery, Gill Gookey, in collaboration with Dr Mike Fray and Loughborough University.)

  We explored the barriers and facilitators to a safe opioid prescribing process in general practice and used the SEIPS v2 framework to analyse the findings (Systems Engineering Initiative for Patient Safety Framework)

  A summary overview of this study is shown on a few slides here.

  SEIPSv2 modelling showing the facilitators for a safe opioid prescribing process:

  

• Creation of a set of minimum standards for a repeat opioid prescribing process in general practice

  We supported Joined Up Care Derbyshire ICD to use the results of the study to create a set of minimum standards which can be tailored to the individual practice

  An overview of this work can be found here.

  The Joined Up Care Derbyshire minimum standards for repeat prescribing of opioids guidance here.

  We have created an adaptable flow chart to support the practice implementation of the guidance and this can be found here.

  There is a quality improvement supporting document to support implementation of this guidance in the Opioid Prescribing Quality Improvement Toolkit For Primary Care (tool six). 

  • QI toolkit opioids for General practice
  • Clinical system searches to support QI opioid toolkit

What is Human Factors?

Human Factors (also called Ergonomics) is “the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data, and methods to design in order to optimize human well-being and overall system performance”. (International Ergonomics Association)

There is a short video that describes Human Factors here.

For other resources to support the management of chronic non-cancer pain and to reduce the harm from opioids please click here.

For any further information on this work please contact Gill Gookey This email address is being protected from spambots. You need JavaScript enabled to view it..