Royal College of Surgeons in Ireland
Evaluation of policies and practices to support safe and appropriate.pdf (440.61 kB)

Evaluation of policies and practices to support safe and appropriate analgesic and sedative prescribing: the CDRx (controlled drug prescribing) protocol

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journal contribution
posted on 2022-06-23, 16:39 authored by Molly MattssonMolly Mattsson, Fiona BolandFiona Boland, Ciara Kirke, Michelle FloodMichelle Flood, Eamonn Quinn, Mary Walsh, Derek Corrigan, Brian MacKenna, Tom FaheyTom Fahey, Emma WallaceEmma Wallace, Frank MoriartyFrank Moriarty
Medications provide many therapeutic benefits; however, these must be balanced against the potential for patient harm. Two high-risk medications are benzodiazepine receptor agonists or BZRAs (including benzodiazepines and Z-drugs hypnotics) and opioid analgesics, which carry a risk of dependence, misuse, and abuse. Use of these medications has been growing internationally, along with associated morbidity and mortality. These medications are often classified as ‘controlled drugs’ and subject to legal restrictions in order to balance therapeutic benefits and risks of misuse. The aim of this project is to evaluate prescribing of analgesic and sedative drugs, in particular opioid and BZRA medications, to characterise time trends, the impact of policy changes, and regional and GP practice variation. This will be addressed across three workpackages, primarily using data on prescriptions dispensed to individuals eligible for the General Medical Services scheme in Ireland, held by the HSE Primary Care Reimbursement Service, along with other national and international data collections. Workpackage 1 will derive volume and patterns of utilisation indicators of controlled drugs and related medications and describe time trends in primary care in Ireland between 2014 and 2021 in two repeated cross-sectional studies. Workpackage 2 will consist of two interrupted time series studies on the impact of recent policy changes on prescribing. Workpackage 3 is a cohort study of GP practices, which will aim to quantify and explain regional and GP practice-level variation in analgesic and sedative prescribing, and, in relation to policy changes. This research will provide data-driven insights to inform policy-makers’ decisions and clinical practice to optimise regulation and use of these medications for the benefit of patients and society.


Health Research Board in Ireland through the Secondary Data Analysis Projects scheme (grant number SDAP-2019-023)



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Published Citation

Mattsson M. et al. Evaluation of policies and practices to support safe and appropriate analgesic and sedative prescribing: the CDRx (controlled drug prescribing) protocol. Res Social Adm Pharm. 2022:S1551-7411(22)00059-6

Publication Date

10 March 2022

PubMed ID



  • Data Science Centre
  • FutureNeuro Centre
  • General Practice
  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Health Professions Education
  • Population Health and Health Services




  • Published Version (Version of Record)