Suggested actions and rationale indicated in prescriber feedback
| Indicator | Suggested action for primary GP | Rationale included in prescriber feedback |
| Patient received opioid therapy for longer than 3 months. | Review use of opioid, taper the dose and cease where appropriate. Help patient understand how pain works and consider referral to an appropriate allied healthcare team to support this. | ‘Current guidelines suggest that there is there is no evidence to support the long-term use of opioids as effective in resolving chronic pain or improving function. Opioid therapy for longer than 90 days is associated with continuing use, opioid use disorders, overdose and worse functional status.’ |
| Patient received more than the recommended maximum dose of 40 mg OME per day. | Review use of opioid, taper the dose and cease where appropriate. Help patient understand how pain works and consider referral to an appropriate allied healthcare team to support this. | ‘Current guidelines suggest that 40mg of oral morphine equivalent (OME) per day is the recommended maximum dose. The risk of adverse effects rises as the opioid dose rises.’ |
| Dose of opioid has exceeded 100 mg OME per day. | Consider referral for a specialist pain evaluation. | ‘Current guidelines suggest that the risk of serious adverse events, including opioid use disorders, overdose and death, increases significantly as the dose exceeds 100mg OME per day.’ |
| Patient coprescribed a benzodiazepine. | Review use of benzodiazepine. | ‘Current guidelines suggest that this combination can depress the central nervous system and increases the risk of death by 15 fold compared to taking neither medicine.’ |
GP, general practitioner.