TY - JOUR
T1 - Association of strong opioids and antibiotics prescribing with GP burnout
T2 - a retrospective cross-sectional study
AU - Hodkinson, Alexander
AU - Zghebi, Salwa S
AU - Kontopantelis, Evangelos
AU - Grigoroglou, Christos
AU - Ashcroft, Darren M
AU - Hann, Mark
AU - Chew-Graham, Carolyn A
AU - Payne, Rupert A
AU - Little, Paul
AU - de Lusignan, Simon
AU - Zhou, Anli
AU - Esmail, Aneez
AU - Panagioti, Maria
N1 - © The Authors.
PY - 2023/8
Y1 - 2023/8
N2 - 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.
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.
KW - Humans
KW - Analgesics, Opioid/therapeutic use
KW - Retrospective Studies
KW - Cross-Sectional Studies
KW - Anti-Bacterial Agents/therapeutic use
KW - Practice Patterns, Physicians'
KW - Burnout, Professional/drug therapy
U2 - 10.3399/BJGP.2022.0394
DO - 10.3399/BJGP.2022.0394
M3 - Article
C2 - 37500457
SN - 0960-1643
VL - 73
SP - e634-e643
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 733
ER -