RT Journal Article
SR Electronic
T1 Association of strong opioids and antibiotics prescribing with GP burnout: a retrospective cross-sectional study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP BJGP.2022.0394
DO 10.3399/BJGP.2022.0394
A1 Alexander Hodkinson
A1 Salwa S Zghebi
A1 Evangelos Kontopantelis
A1 Christos Grigoroglou
A1 Darren M Ashcroft
A1 Mark Hann
A1 Carolyn A Chew-Graham
A1 Rupert A Payne
A1 Paul Little
A1 Simon de Lusignan
A1 Anli Zhou
A1 Aneez Esmail
A1 Maria Panagioti
YR 2023
UL http://bjgp.org/content/early/2023/05/12/BJGP.2022.0394.abstract
AB Background Prescribing 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.Aim To examine associations between strong opioid and antibiotic prescribing and practice- weighted GP burnout and wellness.Design and setting A 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.Method Patients prescribed strong opioids and antibiotics were the outcomes of interest.Results Data 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).Conclusion This 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.