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Data CDRx project: Data analysis of policies and practices for safe, appropriate controlled drug prescribing

Medication safety is a key priority nationally and internationally. ‘Medication Without Harm’ is the theme for the World Health Organisation’s current Global Patient Safety Challenge, and high-risk medication, including benzodiazepine receptor agonists (BZRAs) and opioid analgesics, is one of three focus areas of the challenge. Use of these medications has been growing internationally, along with medication harms including misuse, abuse, and death. These medications are classified as ‘controlled drugs’ and subject to legal restrictions in order to balance therapeutic benefits and risks of misuse.
The aim of this project is to evaluate prescribing of controlled drugs, in particular opioid and BZRA medications, to characterise:
• time trends in volumes and patterns of controlled drug prescribing from 2014 to 2019 in Ireland and England,
• the impact of policy changes on clinical outcomes (drug poisonings and deaths) and medication prescribing (for targeted medications and unintended effects on prescribing of alternative medications), and
• variation in prescribing at regional- and GP practice-level, including factors which explain variation.
The project will also develop a web tool incorporating indicators of controlled drug prescribing to increase accessibility and usability of this data source to inform policy-maker decisions and practice.
It will primarily use data on prescriptions dispensed to individuals eligible for the General Medical Services scheme, held by the HSE Primary Care Reimbursement Service, along with other national and international data collections.
This research will provide data-driven insights to inform policy-makers’ decisions and clinical practice to optimise regulation and use of these medications for the benefit of patients and society. This impact will be driven by members of our project team within key knowledge user organisations (Department of Health, HSE National Quality Improvement Team, Irish College of General Practitioners). Finally, the tool will facilitate evaluation and GP audit to sustain impact and quality improvement beyond this project.