This week’s blog is brought to you by: Professor Alf Collins, Clinical Director for Personalised Care, NHS England and Improvement.

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Full reference and title from the journal:

Link to Public Health England Prescribed Medicines Review – Click here

Authors conclusion

  1. In England in the year 2017 to 2018, 1-in-4 adults in England were prescribed benzodiazepines, z-drugs, gabapentinoids, opioids for chronic non-cancer pain, or antidepressants.
  2. There are large variations in standardised rates of prescribing at the level of CCGs.
  3. The rate of prescribing and the time receiving a prescription increase with deprivation.
  4. Longer-term prescribing is widespread. Aside from antidepressants, the medications reviewed are all licensed and indicated for (usually) short-term treatment of acute conditions.
  5. Patients described not being offered any non-medicinal treatment options, their treatment not being reviewed sufficiently and a lack of access to effective management and NHS support services.

3V bottom line

Dependence forming medications are over-used and represent low value care when used in the long term. Individuals should be supported to understand what is known of the benefits and the harms of these medications alongside other available options before being making a decision about an appropriate course of action.

3VH – Implications for value:

The harms from dependence forming medications are not widely understood- either by patients or professionals. Used in the long term, they represent low value care. Evidence suggests that tailored self management support (eg via face to face or online peer support or formal self management education programmes) are high value interventions for people with long term pain and mental health conditions, yet the availability and uptake of these programmes is patchy. Personalising care through shared decision making and self management support can lead to improved equity and a shift towards higher value service provision.