Evidence map›Paper›PMID 37105724›Full record

ArticleBMJ quality & safety2023

Reducing opioid use for chronic non-cancer pain in primary care using an evidence-based, theory-informed, multistrategic, multistakeholder approach: a single-arm time series with segmented regression.

Anna K Moffat, Jemisha Apajee, Vanessa T Le Blanc, Kerrie Westaway, Andre Q Andrade, Emmae N Ramsay, Natalie Blacker, Nicole L Pratt, Elizabeth Ellen Roughead

Expression of concernOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ quality & safety, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. BMJ quality & safety · 2025
    Article
  3. Article
  4. Article
  5. The Impact of Nonpharmacological Interventions on Opioid Use for Chronic Noncancer Pain: A Scoping Review.International journal of environmental research and public health · 2024
    Article
4 · The record

Corrections and comments

  • Expression of concern
    2025
5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Anna K MoffatClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia.
Jemisha ApajeeFamily and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Vanessa T Le BlancClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia.
Kerrie WestawayClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia.
Andre Q AndradeClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia.ORCID 0000-0001-6587-3169
Emmae N RamsayClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia.
Natalie BlackerClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia.
Nicole L PrattClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia.
Elizabeth Ellen RougheadClinical and Health Sciences, University of South Australia, Adelaide, 5000, South Australia, Australia libby.roughead@unisa.edu.au.ORCID 0000-0002-6811-8991
University of South Australia · AUUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany countries have high opioid use among people with chronic non-cancer pain. Knowledge about effective interventions that could be implemented at scale is limited. We designed a national intervention that included audit and feedback, deprescribing guidance, information on catastrophising assessment, pain neuroscience education and a cognitive tool for use by patients with their healthcare providers.

methodWe used a single-arm time series with segmented regression to assess rates of people using opioids before (January 2015 to September 2017), at the time of (October 2017) and after the intervention (November 2017 to August 2019). We used a cohort with historical comparison group and log binomial regression to examine the rate of psychologist claims in opioid users not using psychologist services prior to the intervention.

results13 968 patients using opioids, 8568 general practitioners, 8370 pharmacies and accredited pharmacists and 689 psychologists were targeted. The estimated difference in opioid use was -0.51 persons per 1000 persons per month (95% CI -0.69, -0.34; p<0.001) as a result of the intervention, equating to 25 387 (95% CI 24 676, 26 131) patient-months of opioid use avoided during the 22-month follow-up. The targeted group had a significantly higher rate of incident patient psychologist claims compared with the historical comparison group (rate ratio: 1.37, 95% CI 1.16, 1.63; p<0.001), equating to an additional 690 (95% CI 289, 1167) patient-months of psychologist treatment during the 22-month follow-up.

conclusionsOur intervention addressed the cognitive, affective and sensory factors that contribute to pain and consequent opioid use, demonstrating it could be implemented at scale and was associated with a reduction in opioid use and increasing utilisation of psychologist services.

Indexed as

Analgesics, OpioidChronic PainHumansPrimary Health CareTime FactorsAnalgesics, OpioidAudit and feedbackGeneral practiceHealthcare quality improvementMedical educationPain

Identifiers

PMID37105724
PMCPMC10646855
OpenAlexW4367175724

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.