GP burnout has been linked to higher opioid and antibiotic prescribing in England, and particularly in deprived areas, according to a new Government-funded study.
Researchers used data for signs of burnout including emotional exhaustion, feeling detached from colleagues and patients, lower job satisfaction and working longer hours.
The study, undertaken by a National Institute for Health and Care Research (NIHR) centre at the University of Manchester, found that GPs working longer hours was associated with a four times greater risk of higher strong opioid and five times greater risk of antibiotic prescribing.
The researchers said their findings suggest wellbeing should be a priority for practices in order to prevent overprescribing.
They found that the risk of increased strong opioid and antibiotic prescribing was also 1.2 times greater among GPs with emotional exhaustion.
There was also a stronger association among GPs based in more deprived areas of the North of England, with the risk being two and 1.6 times greater for increased strong opioid and antibiotic prescribing respectively.
The team at the NIHR Greater Manchester Patient Safety Translational Research Centre (GM PSTRC) used data from a total of 40,227 patients between December 2019 and April 2020, and linked this to burnout scores from 320 GPs across 57 practices.
Dr Alexander Hodkinson, a NIHR senior fellow who works with the GM PSTRC, said: ‘Strong opioids and antibiotic overuse can harm patients in the long-term which is why it is important to prevent their overprescribing.
‘Our findings suggest that one possible way to prevent overprescribing may be to encourage practices to take care of the well-being of their GPs.
‘Perhaps more regular monitoring of the well-being of GPs through health-related surveys, wellness programmes and other measures to improve the working climate might be a helpful way to promote safe and appropriate prescribing strategies.’
Other findings of the study, published last Thursday in the British Journal of General Practice, included:
- Feeling detached was associated with 1.1 times greater risk of higher strong opioid prescribing and 1.2 times greater risk of higher antibiotic prescribing;
- Low job satisfaction was associated with 1.3 times greater risk of higher strong opioid prescribing and 1.1 times greater risk of higher antibiotic prescribing;
- Intention to leave the job was associated with 1.3 times greater risk of higher strong opioid prescribing and 1.4 times greater risk of higher antibiotic prescribing.
Professor Tony Avery, NHS England’s clinical director for prescribing who is also involved with the GM PSTRC, said: ‘As a practising GP, the priority here must be to do everything we can to minimise the risk of burnout in GPs.
‘However, the association between workload, burnout and the use of medicines that may be overprescribed suggests that preventing burnout may help to improve prescribing quality.’
Last month, Professor Avery said at the Pulse Live conference that he no longer refers patients to pain clinics because they end up on even higher strength opioids.
Recent analysis by the Health Foundation found that GPs in the UK experience the highest level of stress and have the lowest job satisfaction compared to doctors in other high-income countries.
And last week, NHS England’s latest QOF guidance revealed that reducing the risk of GP and practice staff burnout will form part of QOF activity from this month.
The abuser blame the practices again.Who is it who trains enough workforce again!NOT
Or…practices in the most deprived areas are associated with patients with more complex medical conditions and have higher rates of opioid and antibiotic prescription. These practices are less well staffed and harder to work in that less deprived areas and hence the doctors working there are at an increased risk of burnout.