ArticleEuropean journal of pain (London, England)2013
The effectiveness of national guidance in changing analgesic prescribing in primary care from 2002 to 2009: an observational database study.
Article in European journal of pain (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Impact of medicines regulatory risk communications in the UK on prescribing and clinical outcomes: Systematic review, time series analysis and meta-analysis.British journal of clinical pharmacology · 2020Pooled it
- Measuring the impact of medicines regulatory interventions - Systematic review and methodological considerations.British journal of clinical pharmacology · 2018Pooled it
- Trial
- Trends in Opioid Prescriptions in Individuals With Axial Spondyloarthritis in the United States and United Kingdom in the Last Two Decades: Analysis of Electronic Health Records and Insurance Claims Data.Arthritis care & research · 2026Observational
- Proactive clinical review of patients taking opioid medicines long term for persistent pain led by clinical pharmacists in primary care teams (PROMPPT): a non-randomised mixed methods feasibility study.Pilot and feasibility studies · 2025Article
- Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study.BJGP open · 2024Article
- Acceptability of a proposed practice pharmacist-led review for opioid-treated patients with persistent pain: A qualitative study to inform intervention development.British journal of pain · 2024Article
- Analgesic prescribing in patients with inflammatory arthritis in England: observational studies in the Clinical Practice Research Datalink.Rheumatology (Oxford, England) · 2024Observational
- Pre-existing musculoskeletal pain and its association with mortality in newly diagnosed co-morbid conditions: an electronic health record cohort study.Rheumatology advances in practice · 2024Article
- Trends in consultations and prescribing for rheumatic and musculoskeletal diseases: an electronic primary care records study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Observational
- The Effect of Ginger and Its Sub-Components on Pain.Plants (Basel, Switzerland) · 2022Review
- Analgesic prescribing in patients with inflammatory arthritis in England: an observational study using electronic healthcare record data.Rheumatology (Oxford, England) · 2022Observational
- Perception of the Regulatory Change for Zolpidem Prescription by French General Practitioners and Its Relation to Prescription Behavior.Journal of clinical medicine · 2022Article
- Price versus clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model.Journal of the Royal Society of Medicine · 2022Article
- Prescription of suboptimal statin treatment regimens: a retrospective cohort study of trends and variation in English primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Investigating musculoskeletal health and wellbeing; a cohort study protocol.BMC musculoskeletal disorders · 2020Article
- A European multicentre drug utilisation study of the impact of regulatory measures on prescribing of codeine for pain in children.Pharmacoepidemiology and drug safety · 2019Article
- Article
- Time trends and geographical variation in prescribing of drugs for diabetes in England from 1998 to 2017.Diabetes, obesity & metabolism · 2018Article
- Analgesic reduction during an interdisciplinary pain management programme: treatment effects and processes of change.British journal of pain · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundNumerous national guidelines have been issued to assist general practitioners' safe analgesic prescribing. Their effectiveness is unclear. The objective of this study was to examine trends in general practitioners' prescribing behaviour in relation to national guidelines.
methodsThis was a retrospective observational database study of registered adult patients prescribed an analgesic (2002-2009) from the Consultations in Primary Care Archive--12 North Staffordshire general practices. Prescribing guidance from the UK Medicines Regulatory Health Authority (MHRA) regarding non-steroidal anti-inflammatory drugs (NSAIDs) and co-proxamol, and the National Institute for Health and Clinical Excellence (NICE) osteoarthritis (OA) management guidelines were considered. Analgesic prescribing rates were examined, arranged according to a classification of six equipotent medication groups: (1) basic analgesics; (2)-(5) increasingly potent opioids and (6) NSAIDs. In each quarter from 2002 to 2009, the number of patients per 10,000 registered population receiving a prescription for the first time from each group was determined. Quarters associated with significant changes in the underlying prescribing trend were determined using joinpoint regression.
resultsA significant decrease in incident co-proxamol and Cox-2 prescribing occurred around the time of the first MHRA advice to stop using them and were rarely prescribed thereafter. The new prescribing of weak analgesics (e.g., co-codamol 8/500) increased at this same time. Initiating topical NSAIDs significantly increased around the time of the NICE OA guidelines.
conclusionsSignificant prescribing changes occurred when national advice and guidelines were issued. The effectiveness of this advice may vary depending upon the content and method of dissemination. Further evaluation of the optimal methods for delivering prescribing guidance is required.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.