Abstract:
BACKGROUND:Opioid prescribing is increasing worldwide with associated increases in misuse and other harms. We studied variations in national opioid prescription rates, indicators of prescribing quality, co-prescribing of benzodiazepines and relationship with pain severity in Scotland. METHODS:Electronic linkages of opioid prescribing in Scotland were determined from: (i) national data from Information Services Division, NHS Scotland (2003-2012); and (ii) individual data from Generation Scotland: Scottish Family Health Study. Descriptive analyses were conducted on national data, multilevel modelling to examine factors associated with variations in prescribing rates. χ2 tests examined associations between individual pain severity and opioid prescriptions. RESULTS:The number of strong opioid prescriptions more than doubled from 474 385 in 2003 to 1 036 446 in 2012, and weak opioid prescribing increased from 3 261 547 to 4 852 583. In Scotland, 938 674 individuals were prescribed an opioid in 2012 (18% of the population). Patients in the most deprived areas were 3.5 times more likely to receive a strong opioid than patients in the least deprived. There was significant variation in prescribing rates between geographical areas, with much of this explained by deprivation. Of women aged 25-40 yr prescribed a strong opioid, 40% were also prescribed a benzodiazepine. There was significant association between pain severity and receipt of opioid prescription. Over 50% of people reporting severe pain were not prescribed an opioid analgesic. CONCLUSIONS:We found opioid prescribing in primary care to be common and increasing in Scotland, particularly for severe pain. Co-prescribing of opioids and benzodiazepines was common.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Torrance N,Mansoor R,Wang H,Gilbert S,Macfarlane GJ,Serpell M,Baldacchino A,Hales TG,Donnan P,Wyper G,Smith BH,Colvin Ldoi
10.1016/j.bja.2018.02.022subject
Has Abstractpub_date
2018-06-01 00:00:00pages
1345-1355issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(18)30134-Xjournal_volume
120pub_type
杂志文章abstract::We have studied the immediate and long term (up to 28 days) effects of short and long bevelled needle impalement of the rat sciatic nerve. Three techniques were used to assess neural trauma and its consequences: stained longitudinal nerve sections were assessed by light microscopy and scored for injury; the extravasat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.5.433
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journal_title:British journal of anaesthesia
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doi:10.1093/bja/aeg186
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abstract:BACKGROUND:Better education of clinicians is expected to enhance patient safety. An important component of education is adherence to standard protocols, which are mainly available in written form. Believing in the potential power of videos, we hypothesized that the introduction of an educational video, based on an inst...
journal_title:British journal of anaesthesia
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doi:10.1093/bja/aew030
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.1.106
更新日期:1996-01-01 00:00:00
abstract::In a random, double-blind crossover trial using an ischaemic limb pain model we have assessed the speed of onset of analgesia after an i.v. bolus of equipotent doses of diamorphine and morphine in 12 healthy male volunteers. Pain and its subsequent relief were assessed by means of a visual analogue scale. Two of the s...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-06-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1999-05-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::The effects of doxacurium chloride, a new long-acting non-depolarizing neuromuscular blocking drug, on cardiac performance were studied in 45 patients undergoing high-dose fentanyl-diazepam-oxygen anaesthesia for cardiac surgery. Data were collected at baseline (10 min after tracheal intubation), and at 2, 5 and 10 mi...
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abstract::A variant of a rebreathing/indicator-dilution technique was used to measure lung volume. Two or three indicators, which should have essentially the same pulmonary volume of distribution, were used. Gas compositions were measured by respiratory mass spectrometry and an extrapolation was used to allow for oxygen consump...
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1989-11-01 00:00:00
abstract::The fate of gallamine triethiodide has been investigated in patients undergoing cholecystectomy with choledochostomy (group I), pelvic operations (group II) and orthopaedic operations (group III). Following a single i.v. injection of gallamine 2.5 mg kg(-1) the disappearance of the drug from the serum occurred in thre...
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pub_type: 杂志文章
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更新日期:2018-02-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.11.1229
更新日期:1984-11-01 00:00:00
abstract::We report a case of improved cardiopulmonary exercise (CPX) test outcomes measured 48 h after initial CPX testing and immediately after alterations were made to the settings of a dual chamber, dual sensing pacemaker with exercise detection. The changes allowed successful abdominal surgery to be completed. ...
journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
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journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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