Description

Taken from high dose long-acting opioid codelist in OpenPrescribing, with a calculated Oral Morphine Equivalence of ≥120mg a day of a long acting regular opioid.

From OpenPrescribing: "The calculations are based on likely doses of long acting, regular opioids, for example morphine sulphate tablets or fentanyl patches. For example, we have assumed that MST 60mg tablets are “high dose”, as they are usually taken as one tablet twice daily (120mg daily dose), whereas MST 30mg are not, as the daily dose is 60mg. We have not included preparations used for breakthrough pain, e.g. Oramorph, or opioid injections which tend to be used more commonly in palliative care. "

Methodology

Using SQL from the measure definition for the numerator for this measure in OpenPrescribing, a bnf codelist was built in BigQuery:

select presentation_code, presentation

from hscic.bnf

where (presentation_code LIKE '0407020A0%AF' OR

presentation_code LIKE '0407020A0%AG' OR

presentation_code LIKE '0407020A0%AH' OR

presentation_code LIKE '0407020AD%AH' OR

presentation_code LIKE '0407020AD%AI' OR

presentation_code LIKE '0407020AD%AP' OR

presentation_code LIKE '0407020AD%AQ' OR

presentation_code LIKE '0407020AF%AD' OR

presentation_code LIKE '0407020AG%AF' OR

presentation_code LIKE '0407020AG%AG' OR

presentation_code LIKE '0407020B0%AF' OR

presentation_code LIKE '0407020B0%AG' OR

presentation_code LIKE '0407020Q0%AG' OR

presentation_code LIKE '0407020Q0%AH' OR

presentation_code LIKE '0407020Q0%AI' OR

presentation_code LIKE '0407020Q0%DC' OR

presentation_code LIKE '0407020Q0%DD' OR

presentation_code LIKE '0407020Q0%DU' OR

presentation_code LIKE '0407020Q0%DV' OR

presentation_code LIKE '0407020Q0%DW' OR

presentation_code LIKE '0407020Q0%EB' OR

presentation_code LIKE '0407020Q0%EH' OR

presentation_code LIKE '0407020Q0%EI')

AND presentation_code NOT IN ('0407020Q0BIACDU','0407020Q0BIABEH')

Following a codelist review, small changes were made, and the openprescribing definition was changed to match this codelist.

References

• Measure definition - high dose opioid items as percentage regular opioids

Signed off by

• Richard Croker, (Aug. 16, 2022)
• Chris Wood, (Aug. 16, 2022)