RecruitingInterventional

Developing and testing approaches to support primary care practices to reduce harmful opioid prescribing (Opioid SMART)

This study, called Opioid SMART, aims to find the best ways to help GP practices reduce how often strong pain medicines, called opioids, are prescribed. Opioids are very powerful, but they can also cause addiction and other health problems. Researchers previously ran a program that helped many practices reduce opioid use, but some found it harder to change. This new study will test different types of support for practices in Yorkshire, including giving them reports on their prescribing habits and offering extra help from trained experts. By testing these approaches, the researchers hope to learn how to best support practices to prescribe opioids more safely, helping many patients in the long run. The study will also look at whether these new ways of working are practical to use in real-life GP settings.

At a glance

Status

Recruiting

Sponsor

University of Leeds

Enrolment target

Start

01 Apr 2025

Estimated completion

31 Aug 2026

Opioid prescribing in primary care

What is this study about?

Opioids are strong pain medicines, like morphine, that doctors sometimes prescribe. While they can be very helpful for severe pain, they can also lead to addiction and increase risks for things like falls. A few years ago, a program in West Yorkshire successfully helped many GP practices reduce how many opioid prescriptions they gave out. This involved sending practices reports that made doctors think carefully before starting new opioid prescriptions or renewing old ones. This was great news, as it led to 15,000 fewer patients being given these medicines!

However, some practices found it more difficult to reduce their opioid prescribing, and others took a longer time to make changes. This study is designed to find out if giving struggling practices extra support from a trained helper, known as a 'feedback facilitator', can make a real difference. These facilitators would visit practices to help them understand their reports and make plans to prescribe opioids more safely. Because bringing in facilitators costs time and money, it's important to know exactly when and how this extra help works best.

So, this study will test different ways of supporting GP practices in Yorkshire. It will look at how two different approaches work: one where practices only get the reports, and another where they get the reports plus the extra support from a facilitator. The main goal is to see if these approaches are practical to use in GP surgeries and if they help reduce opioid prescribing. The information gathered from this study will be used to plan a larger study in the future, with the ultimate aim of helping more practices across the country prescribe opioids more safely for everyone.

Key takeaways

The study aims to find the best ways to help GP practices reduce prescribing strong pain medicines called opioids.
Opioids can be addictive and carry health risks, so safer prescribing is important.
Practices in Yorkshire will test two ways to get help: reports only, or reports plus support from an expert.
The work will help plan a bigger study to improve opioid prescribing across the UK.
Taking part involves a small time commitment for GP practices.
The study is about improving practices' prescribing habits, not directly changing individual patient care.

Who may be eligible?

This study is taking place in Yorkshire. To be part of the study, GP practices must have taken part in a similar program called CROP before. They also can't be part of any other similar programs aiming to reduce opioid prescribing right now. Practices also need to be able to name a doctor or staff member who will be in charge of the study within their practice, and they must be willing to try the 'feedback facilitation' support.

Individual staff members at these practices can also be involved. If you are a healthcare staff member with a role in prescribing medicines or improving quality in the practice during the study, you might be asked to take part in an interview about your thoughts on the support received.

Practices will not be able to join if they focus on providing specialist services for drug addiction, or if they are already among the very lowest prescribers of opioids in their area. For staff interviews, you won't be able to take part if you can't give written permission or can't meet for an interview in person or online.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Is your GP practice in Yorkshire and has it taken part in the CROP program before?
Is your practice NOT already involved in another programme to reduce opioid prescribing?
Can your practice name a lead person for this study?
Is your practice willing to potentially receive support visits from a trained expert?
If you are a staff member, do you have a prescribing or quality improvement role at your practice?

Answer every question to see your result.

What does participation involve?

If your GP practice takes part, it will be one of eight practices in South Yorkshire in this study. You will be randomly put into one of two groups: half the practices will receive regular reports about their opioid prescribing, and the other half will receive these reports plus extra support from a trained expert who will visit to help. The study aims to make sure these approaches are practical and useful for GP surgeries.

Several staff members from each participating practice will also be asked to have a private, one-on-one chat (interview) to share their thoughts on the support their practice received. The study is expected to run from July 2023 to March 2026, so practices would be involved for a portion of this time.

Potential risks and benefits

The possible benefits for practices taking part include the chance that the support they receive could help them reduce opioid prescribing, which is good for patient safety. The findings from this study will also help create a larger study that could benefit many more GP practices across the UK. Taking part can also count as a helpful quality improvement activity for practice reviews. The risks are expected to be very low. The main downside is that staff at participating practices will need to set aside a small amount of time for the support sessions. You always have the right to withdraw from the study at any time.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

NHS South Yorkshire Integrated Care Board
City only
-, England

Common questions

What exactly are opioids?

Opioids are strong pain medicines, like codeine or morphine, that doctors prescribe for severe pain. They can be very effective but also carry risks like addiction.

Why is reducing opioid prescribing important?

While helpful for pain, opioids can lead to addiction and other serious health problems, such as an increased risk of falls or even death. Reducing unnecessary prescribing makes treatment safer.

What is 'feedback facilitation'?

This is when a trained expert visits a GP practice to help them understand their prescribing data and develop plans to improve and reduce opioid use more safely.

Will this study affect my own prescriptions?

This study is about how GP practices make decisions about prescribing in general. Your individual care and prescriptions will always be decided by your doctor based on what's best for you.

Who is paying for this research?

The study is funded by a national organisation called the National Institute for Health and Care Research (NIHR) in the UK.

How to find out more

Sarah Alderson

s.l.alderson@leeds.ac.uk +44 (0)113 3430867 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.