GP patients are not being ‘sufficiently warned’ about the dependence risks or withdrawal symptoms associated with prescribed drugs like opioids, benzodiazepines, gabapentinoids, anti-depressants and ‘z-drugs’ such as zopiclone, according to a two-year study by researchers at Oxford Brookes University.
Among the concerns highlighted by patients were a lack of detailed information about the drugs when first prescribed, along with a lack of information about alternative treatments. Many stated that they were unaware of the dependence risks, with problems in continuity of care also exacerbated by issues like lengthy waiting times and not being able to see the same clinician.
Making sure that patients receive detailed information at the point of prescription is vital, says the National Institute for Health and Care Research (NIHR)-funded study, which is published in the journal BMC Primary Care. Patients could be signposted to information online or by automated texts, it says, adding that continuity of care should be prioritised for patients prescribed medications that carry a risk of dependence or withdrawal. ‘One of the ways this could be achieved is by creating small teams of two to three clinicians working in partnership,’ it states.
A 2019 review by Public Health England found that a quarter of adults had been prescribed an opioid, benzodiazepine, ‘z’ drugs, gabapentinoid or antidepressant during the previous year, with half prescribed the drugs for a year and a third for three years or more – despite benzodiazepines not being recommended for use of more than a month (https://www.drinkanddrugsnews.com/prescription-drug-addiction-phe-review/).
Last year NHS England published a framework for action stating that health professionals needed to regularly discuss prescriptions with their patients and offer alternatives where appropriate. Services for people experiencing withdrawal symptoms and alternative treatments should also be built into service specifications, it stated (https://www.drinkanddrugsnews.com/nhs-england-publishes-new-action-framework-for-prescription-drugs/).
‘Significant concerns have been raised by Public Health England and the British Medical Association regarding how medications with a risk of dependence or withdrawal are managed and how care is experienced by patients,’ said study lead Dr Jennifer Seddon. ‘This study not only highlights the main areas of concern from the perspective of patients and healthcare professionals, but also suggests ways to address these concerns to improve the patient experience of care. We hope that the results of this study will lead to change in the way these medications are managed within primary care, and will result in wider improvements to the patient experience.’