Description

Taken from long-acting opioid denominator 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 denominator for this measure in OpenPrescribing, a bnf codelist was built in BigQuery, which also removed any drugs from the denominator which was also in the numerator, leaving only lower OME products: select presentation_code, presentation from hscic.bnf where (presentation_code LIKE '0407020A0%AE' OR presentation_code LIKE '0407020A0%AF' OR presentation_code LIKE '0407020A0%AG' OR presentation_code LIKE '0407020A0%AH' OR presentation_code LIKE '0407020A0%AU' OR presentation_code LIKE '0407020A0%BW' OR presentation_code LIKE '0407020AD%AF' OR presentation_code LIKE '0407020AD%AG' OR presentation_code LIKE '0407020AD%AH' OR presentation_code LIKE '0407020AD%AI' OR presentation_code LIKE '0407020AD%AK' OR presentation_code LIKE '0407020AD%AP' OR presentation_code LIKE '0407020AD%AQ' OR presentation_code LIKE '0407020AD%AR' OR presentation_code LIKE '0407020AD%AS' OR presentation_code LIKE '0407020AF%AA' OR presentation_code LIKE '0407020AF%AB' OR presentation_code LIKE '0407020AF%AC' OR presentation_code LIKE '0407020AF%AD' OR presentation_code LIKE '0407020AG%AC' OR presentation_code LIKE '0407020AG%AD' OR presentation_code LIKE '0407020AG%AE' OR presentation_code LIKE '0407020AG%AF' OR presentation_code LIKE '0407020AG%AG' OR presentation_code LIKE '0407020B0%AE' OR presentation_code LIKE '0407020B0%AF' OR presentation_code LIKE '0407020B0%AG' OR presentation_code LIKE '0407020B0%AH' OR presentation_code LIKE '0407020B0%AI' OR presentation_code LIKE '0407020B0%AJ' OR presentation_code LIKE '0407020Q0%AG' OR presentation_code LIKE '0407020Q0%AH' OR presentation_code LIKE '0407020Q0%AI' OR presentation_code LIKE '0407020Q0%AK' OR presentation_code LIKE '0407020Q0%AL' OR presentation_code LIKE '0407020Q0%CF' OR presentation_code LIKE '0407020Q0%CG' OR presentation_code LIKE '0407020Q0%CP' OR presentation_code LIKE '0407020Q0%CV' OR presentation_code LIKE '0407020Q0%DC' OR presentation_code LIKE '0407020Q0%DD' OR presentation_code LIKE '0407020Q0%DE' OR presentation_code LIKE '0407020Q0%DU' OR presentation_code LIKE '0407020Q0%DV' OR presentation_code LIKE '0407020Q0%DW' OR presentation_code LIKE '0407020Q0%DZ' OR presentation_code LIKE '0407020Q0%EA' OR presentation_code LIKE '0407020Q0%EB' OR presentation_code LIKE '0407020Q0%EF' OR presentation_code LIKE '0407020Q0%EG' OR presentation_code LIKE '0407020Q0%EH' OR presentation_code LIKE '0407020Q0%EI' OR presentation_code LIKE '0407020Q0%FL') AND presentation_code NOT IN ('0407020A0AAAFAF', '0407020A0AAAGAG', '0407020A0AAAHAH', '0407020A0BBABAF', '0407020A0BBACAG', '0407020A0BBADAH', '0407020A0BBAJAF', '0407020A0BBAKAG', '0407020A0BBALAH', '0407020A0BDABAF', '0407020A0BDACAG', '0407020A0BDADAH', '0407020A0BEACAF', '0407020A0BEADAG', '0407020A0BEAEAH', '0407020A0BFACAF', '0407020A0BFADAG', '0407020A0BFAEAH', '0407020A0BGABAF', '0407020A0BGACAG', '0407020A0BGADAH', '0407020A0BHABAF', '0407020A0BHACAG', '0407020A0BHADAH', '0407020A0BLABAF', '0407020A0BLACAG', '0407020A0BLADAH', '0407020A0BMABAF', '0407020A0BMACAG', '0407020A0BMADAH', '0407020A0BQACAF', '0407020A0BQADAG', '0407020A0BQAEAH', '0407020A0BRACAG', '0407020A0BRADAH', '0407020A0BRAEAF', '0407020A0BRAHAF', '0407020A0BRAIAG', '0407020A0BRAJAH', '0407020A0BRAMAF', '0407020A0BRANAG', '0407020A0BRAPAH', '0407020A0BUACAF', '0407020A0BUADAG', '0407020A0BUAEAH', '0407020A0BVACAF', '0407020A0BVADAG', '0407020A0BVAEAH', '0407020ADAAAHAH', '0407020ADAAAIAI', '0407020ADAAAPAP', '0407020ADAAAQAQ', '0407020ADBCACAH', '0407020ADBCADAI', '0407020ADBCAFAP', '0407020ADBCAGAQ', '0407020ADBDADAH', '0407020ADBDAEAI', '0407020ADBEADAH', '0407020ADBEAEAI', '0407020ADBEAFAP', '0407020ADBEAIAQ', '0407020ADBFADAH', '0407020ADBFAEAI', '0407020ADBFAIAH', '0407020ADBFAJAI', '0407020ADBGADAH', '0407020ADBGAEAI', '0407020ADBIABAH', '0407020ADBKADAH', '0407020ADBKAEAI', '0407020ADBKAHAQ', '0407020ADBLABAI', '0407020ADBLADAQ', '0407020ADBLAEAH', '0407020ADBMAEAH', '0407020ADBMAGAQ', '0407020ADBMAHAI', '0407020ADBNAAAI', '0407020ADBNABAH', '0407020ADBPAEAH', '0407020ADBPAFAQ', '0407020ADBPAGAI', '0407020ADBQACAH', '0407020ADBQADAI', '0407020ADBRAFAH', '0407020ADBRAGAQ', '0407020ADBSAFAH', '0407020ADBSAGAQ', '0407020ADBSAHAI', '0407020ADBTAFAH', '0407020ADBTAGAQ', '0407020ADBTAHAI', '0407020AFAAADAD', '0407020AFBBADAD', '0407020AFBCACAD', '0407020AFBDADAD', '0407020AGAAAFAF', '0407020AGAAAGAG', '0407020AGBBAFAF', '0407020AGBBAGAG', '0407020AGBCAEAF', '0407020AGBCAFAG', '0407020B0AAAFAF', '0407020B0AAAGAG', '0407020B0BDABAF', '0407020B0BDACAG', '0407020B0BGABAF', '0407020B0BGACAG', '0407020B0BIABAF', '0407020B0BIACAG', '0407020B0BJABAF', '0407020B0BJACAG', '0407020B0BNABAF', '0407020B0BNACAG', '0407020B0BPABAF', '0407020B0BPACAG', '0407020B0BSABAF', '0407020B0BSACAG', '0407020B0BTABAF', '0407020B0BTACAG', '0407020Q0AAAGAG', '0407020Q0AAAHAH', '0407020Q0AAAIAI', '0407020Q0AADCDC', '0407020Q0AADDDD', '0407020Q0AADEDE', '0407020Q0AADUDU', '0407020Q0AADVDV', '0407020Q0AADWDW', '0407020Q0AAEBEB', '0407020Q0AAEHEH', '0407020Q0AAEIEI', '0407020Q0BBACAI', '0407020Q0BBADAH', '0407020Q0BBAEAG', '0407020Q0BBAHDC', '0407020Q0BBAIDD', '0407020Q0BBAJDE', '0407020Q0BIADDV', '0407020Q0BIAEDW', '0407020Q0BIAFEI', '0407020Q0BJACEB', '0407020Q0BKACEH', '0407020Q0BKADEB', '0407020Q0BKAEEI', '0407020Q0BMACAI', '0407020Q0BMADAH', '0407020Q0BMAEAG', '0407020Q0BNACAI', '0407020Q0BNADAH', '0407020Q0BPACAI', '0407020Q0BPADAH')

References

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

Signed off by

• Richard Croker, (Aug. 8, 2022)
• Chris Wood, (Aug. 16, 2020)