Publication - Advice and guidance
Quality prescribing for chronic pain: guide for improvement 2026-2029
Chronic pain, defined as persistent pain lasting beyond three months, can significantly impact quality of life, affecting physical and mental wellbeing. This guide supports clinicians and people living with chronic pain, using a person-centred approach to pain management.
15. Appendix B: National Therapeutic Indicators in chronic pain
| Indicator Name | Description | Output | Comments |
|---|---|---|---|
| Analgesics (gabapentinoid DDDs) | Pregabalin and gabapentin DDDs per 1,000 list size per day | Number | Retain |
| Analgesics (gabapentinoid DDDs) (weighted) | Pregabalin and gabapentin DDDs per 1,000 list size per day(weighted) | Number | Retain |
| Analgesics (opioid DDDs) | Strong opioids (including tramadol preparations) DDDs per 1,000 list size per day | Number | Retain |
| Analgesics (opioid DDDs) opioids excluding tramadol | Strong opioids (excluding tramadol preparations) DDDs per 1,000 list size per day | Number | Retain |
| Analgesics (opioid DDDs) tramadol only | Tramadol preparations DDDs per 1,000 list size per day | Number | Retain |
| Analgesics (opioid DDDs) weighted | Strong opioids (including tramadol preparations) DDDs per 1,000 list size per day (weighted) | Number | Retain |
| Analgesics (opioid DDDs) opioids excluding tramadol (weighted) | Strong opioids (excluding tramadol preparations) DDDs per 1,000 list size per day (weighted) | Number | Retain |
| Analgesics (opioid DDDs) tramadol only (weighted) | Tramadol preparations DDDs per 1,000 list size per day (weighted) | Number | Retain |
| Topical Anaesthetic (lidocaine plaster costs) | Lidocaine plaster cost per 1,000 list size | Cost (£) | Retain |
| Topical Anaesthetic (lidocaine plaster costs) weighted | Lidocaine plaster cost per 1,000 list size (weighted) | Cost (£) | Retain |
| Gabapentinoid dependency (high dose gabapentinoids %) | Number of people prescribed a gabapentinoid at an average daily dose equivalent to >3900mg (Pregabalin >650mg) gabapentin over the previous 6 months as a percentage of all people prescribed a gabapentinoid | Percentage | 1,000 Per 1,000 and weighted pt |
| Opioid and gabapentinoid dependency (high dose opioids %) 120mg | Number of people prescribed an opioid at an average daily dose of opioid equivalent to >= 120mg per day of morphine over the previous 6 months as a percentage of all people prescribed step 2 and strong opioids | Percentage | Retire |
| Opioid and gabapentinoid dependency (high dose opioids %) 50mg | Number of people prescribed an opioid at an average daily dose of opioid equivalent to >= 50mg per day of morphine over the previous 6 months | Percentage | per 1,000 weighted pt |
| Opioid and gabapentinoid dependency (long term opioids %) | Number of people prescribed strong opioids (including tramadol preparations) long term (>1 years) | Percentage | per 1,000 weighted pt |
| Opioid and gabapentinoid dependency (high dose opioids %) 90mg | Number of people prescribed an opioid at an average daily dose of opioid equivalent to >= 90mg per day of morphine over the previous 6 months | Percentage | per 1,000 weighted pt |
| Indicator Name | Description | Output | Comments |
|---|---|---|---|
| Opioid, a benzodiazepine/ z-drug or a Gabapentinoid combination | Number of people prescribed 2 out of 3 of an opioid, a benzodiazepine/ -drug or a Gabapentinoid in previous 3 months per 1,000 (weighted patients) | Per 1,000 list size | New |
| Opioid, a benzodiazepine/ z-drug or a Gabapentinoid combination |
Current STU search for information -IND_MH17 All people registered with the practice prescribed a benzodiazepine/z-drug plus an opioid on active repeat or issued on repeat or acute in the past 84 days |
- | - |
| Opioid and gabapentinoid dependency (long term gabapentinoid %) |
Number of patients prescribed gabapentinoids for >6months per 1000 (weighted) patients |
People per 1,000 list size | New |
| Lidocaine indicator | Add additional number of people prescribed indicator | People per 1,000 list size | New |
| Strong opioids | Number of people prescribed strong opioids (including tramadol preparations) long term (>3 months) | People per 1,000 list size | New |
|
Weak opioid indicator. |
Number of people prescribed weak opioids long term (>1 year) (per 1,000 list size) | People per 1,000 list size | New |
| Teratogenic risk |
Women 0 – 54 yrs on a Gabapentinoid medication No weighted option available for this search |
People per 1,000 list size | New |
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Email: EPandT@gov.scot