National survey of Australian GPs to explore opioid prescribing practices, knowledge, and attitudes

Project: Research

Project Description

Background

Opioid medications (including morphine, oxycodone, codeine and tramadol) are commonly used in general practice (GP) to treat moderate and severe pain [1]. However, doctors are cautious when prescribing opioids because of the risks of misuse, abuse, addiction and diversion into illicit channels and recreational drugs [2].

As opioid prescribing rates have increased in general practice, so too have opioid-related death rates [3]. In fact, pharmaceutical opioids now cause more fatal opioid-related overdoses than illicit heroin [3]. Various stakeholders concerned about unsafe opioid prescribing in Australia have therefore called for patient-centred, prescriber-centred and systems-level interventions to improve opioid prescribing [3-8].

Despite the crucial role GPs have in managing chronic pain, there are no published Australian studies that explore the self reported opioid prescribing practices of GPs. This information would provide invaluable insights to guide the development of
prescriber-targeted interventions to improve quality and safety in opioid prescribing in general practice [5, 7, 9]. Quantitative prescribing data is available from the Pharmaceutical Benefits Scheme (PBS) and Bettering the Evaluation And Care of Health
(BEACH) publications, but there are no published survey studies of the opioid prescribing practices of Australian GPs [6, 10].

Primary aim
To determine the self-reported opioid prescribing practices and concerns of Australian GPs and GP registrars

Secondary aims
To compare opioid prescribing of registrar/trainee GPs, early career, mid-career and senior GPs
To compare opioid prescribing between rural, regional and urban GPs
The outcomes from my research will inform the development of a complex behaviour change intervention targeting GPs to improve community health and reduce unsafe prescription opioid use.

Methods

Building upon the findings of qualitative research I have undertaken in 2018, Australian GPs will be surveyed about their opioid prescribing practices, major concerns and limitations influencing prescribing. Additionally they will be surveyed about their level of pain management education and knowledge, past experiences and access to prescribing support. A nationally representative sample of approximately 380 GPs will be recruited using contact information derived from the Australasian
Medical Publishing Company (AMPCo) database. GPs will be asked to complete an anonymous, survey expected to take between 5 and 15 minutes. Participants may enter a prize draw to win an iPad Pro on completion of the survey. A statistician
will assist our statistical analysis of the data from the survey.

Significance of proposal

Encouraging safe evidence-based opioid prescribing is a public health priority. To date there have been no published surveys of the self-reported knowledge, beliefs and concerns of Australian GPs in prescribing these medications. This research is expected
to have marked implications for various stakeholders (including GPs and registrars, the RACGP and GP training providers, pharmacists, police, and the Coroner’s Court) and provide a novel data set for future research. Additionally, the study will provide information that will help develop an intervention targeted at GPs to improve their opioid prescribing and ultimately improve patient safety.
StatusActive
Effective start/end date1/02/1931/12/19

Funding

  • Shepherd Foundation: AUD39,152.00