The following is a summary of “Assessing the feasibility of the GOTT (Gabapentinoid and Opioid Tapering Toolkit) in a primary care setting in North-East England,” published in the October 2024 issue of Pain by Johnson et al. 

Researchers conducted a retrospective study to examine the feasibility and potential impact of systematic non-pharmacological interventions to reduce opioid and gabapentinoid analgesic prescribing for chronic non-cancer pain (CNCP), particularly high-dose prescriptions, in a deprived primary care practice in North-East England.  

They involved 25 primary care staff, including 18 clinicians, in the intervention. All clinicians underwent an educational skills program aimed at enhancing patient pain self-management, tailored to the self-assessed learning needs, which integrated clinician skill development and patient self-care resources into a GP clinical management computer system for quick access during consultations. Clinical staff completed questionnaires before and after the Gabapentinoid and Opioid Toolkit (GOTT) intervention to evaluate their knowledge levels and confidence in supporting chronic pain self-management across various domains. Prescription data were analyzed to track changes in opioid and gabapentinoid prescribing practices over the 12-month intervention and 30-month follow-up period.  

The results showed that prescribing of opioids and gabapentinoids/pregabalin significantly decreased, with approximately a 90% reduction in high-dose opioid prescriptions (P = .0118) and a 15% decrease in gabapentin/pregabalin prescriptions over 1 year during the COVID-19 pandemic and follow-up analysis in December 2022 indicated a 100% reduction for opioids and about a 50% reduction for gabapentinoids. Questionnaire data demonstrated an overall increase in clinician confidence in enabling self-management throughout the intervention (P = .044), specifically in 3 of the 5 measured domains: supporting behavioral change (P = .028), supporting self-care (P = .008), and managing complex consultations (P = .011).  

They concluded the GOTT intervention program provided initial evidence of a proof-of-concept for a systematic non-pharmacological pain management program, addressing skill gaps and reducing the use of potent opioids and gabapentinoids. 

Source: journals.sagepub.com/doi/10.1177/20494637241291534