Evidence map›Paper›PMID 37500457›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2023

Association of strong opioids and antibiotics prescribing with GP burnout: a retrospective cross-sectional study.

Alexander Hodkinson, Salwa S Zghebi, Evangelos Kontopantelis, Christos Grigoroglou, Darren M Ashcroft, Mark Hann, Carolyn A Chew-Graham, Rupert A Payne, Paul Little, Simon de Lusignan and 3 more

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In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.9field-weighted citation impact, top 7% 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

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Adoption of clinical pharmacist roles in primary care: longitudinal evidence from English general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  4. Exploring rural Scottish GPs' migration decisions: a secondary qualitative analysis considering burnout.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 3 countries.

Alexander HodkinsonNIHR School for Primary Care Research and NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester.ORCID 0000-0003-2063-0977
Salwa S ZghebiNIHR School for Primary Care Research, University of Manchester, Manchester.ORCID 0000-0002-7978-1094
Evangelos KontopantelisNIHR School for Primary Care Research; Division of Informatics, University of Manchester, Manchester.ORCID 0000-0001-6450-5815
Christos GrigoroglouNIHR School for Primary Care Research; Manchester Centre for Health Economics, University of Manchester, Manchester.ORCID 0000-0003-1621-8648
Darren M AshcroftNIHR School for Primary Care Research; NIHR Greater Manchester Patient Safety Translational Research Centre; Centre for Pharmacoepidemiology and Drug Safety, University of Manchester, Manchester.ORCID 0000-0002-2958-915X
Mark HannNIHR School for Primary Care Research, University of Manchester, Manchester.ORCID 0000-0002-4508-5584
Carolyn A Chew-GrahamSchool of Medicine, Keele University, Keele.ORCID 0000-0002-9722-9981
Rupert A PayneExeter Collaboration for Academic Primary Care, University of Exeter Medical School, Exeter.ORCID 0000-0002-5842-4645
Paul LittlePrimary Care Research Centre, University of Southampton, Southampton.ORCID 0000-0003-3664-1873
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford; Royal College of General Practitioners Research and Surveillance Centre, London.ORCID 0000-0002-8553-2641
Anli ZhouNIHR School for Primary Care Research, University of Manchester, Manchester.ORCID 0000-0003-2402-8289
Aneez EsmailNIHR School for Primary Care Research, University of Manchester, Manchester.ORCID 0000-0001-7061-7434
Maria PanagiotiNIHR School for Primary Care Research and NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester.ORCID 0000-0002-7153-5745
University of Manchester · GBManchester Academic Health Science Centre · GBNIHR Manchester Biomedical Research Centre · GBKeele University · GBNIHR Southampton Biomedical Research Centre · GBUniversity of Exeter · GBUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrescribing of strong opioids and antibiotics impacts patient safety, yet little is known about the effects GP wellness has on overprescribing of both medications in primary care.

aimTo examine associations between strong opioid and antibiotic prescribing and practice- weighted GP burnout and wellness. DESIGN AND

settingA retrospective cross-sectional study was undertaken using prescription data on strong opioids and antibiotics from the Oxford- Royal College of General Practitioners Research and Surveillance Centre linking to a GP wellbeing survey overlaying the same 4-month period from December 2019 to April 2020.

methodPatients prescribed strong opioids and antibiotics were the outcomes of interest.

resultsData for 40 227 patients (13 483 strong opioids and 26 744 antibiotics) were linked to 57 practices and 351 GPs. Greater strong opioid prescribing was associated with increased emotional exhaustion (incidence risk ratio [IRR] 1.19, 95% confidence interval [CI] = 1.10 to 1.24), depersonalisation (IRR 1.10, 95% CI = 1.01 to 1.16), job dissatisfaction (IRR 1.25, 95% CI = 1.19 to 1.32), diagnostic uncertainty (IRR 1.12, 95% CI = 1.08 to 1.19), and turnover intention (IRR 1.32, 95% CI = 1.27 to 1.37) in GPs. Greater antibiotic prescribing was associated with increased emotional exhaustion (IRR 1.19, 95% CI = 1.05 to 1.37), depersonalisation (IRR 1.24, 95% CI = 1.08 to 1.49), job dissatisfaction (IRR 1.11, 95% CI = 1.04 to 1.19), sickness-presenteeism (IRR 1.18, 95% CI = 1.11 to 1.25), and turnover intention (IRR 1.38, 95% CI = 1.31 to 1.45) in GPs. Increased strong opioid and antibiotic prescribing was also found in GPs working longer hours (IRR 3.95, 95% CI = 3.39 to 4.61; IRR 5.02, 95% CI = 4.07 to 6.19, respectively) and in practices in the north of England (1.96, 95% CI = 1.61 to 2.33; 1.56, 95% CI = 1.12 to 3.70, respectively).

conclusionThis study found higher rates of prescribing of strong opioids and antibiotics in practices with GPs with more burnout symptoms, greater job dissatisfaction, and turnover intentions; working longer hours; and in practices in the north of England serving more deprived populations.

Indexed as

Analgesics, OpioidBurnout, ProfessionalAnti-Bacterial AgentsCross-Sectional StudiesHumansPractice Patterns, Physicians'Retrospective StudiesAnalgesics, OpioidAnti-Bacterial Agentsantibioticsburnouthazardous prescribingopioidspatient safetyprimary care

Identifiers

PMID37500457
PMCPMC10227993
OpenAlexW4361858466

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.