Article Text

Download PDFPDF
Better opioid prescribing in an inpatient oncology unit: quality improvement project
  1. Anna Weil1,2,
  2. Shan Shan Vijeratnam1,3,
  3. Valerie Potter1,
  4. Jaymi Teli1 and
  5. David Feuer1,4
  1. 1 Department of Palliative Medicine, St Bartholomew's Hospital, London, UK
  2. 2 Community Palliative Care Team, St Joseph's Hospice, London, UK
  3. 3 Community Palliative Care Team, St Francis Hospice, Romford, UK
  4. 4 Department of Palliative Medicine, Homerton University Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Shan Shan Vijeratnam, St Bartholomew's Hospital, London, London, UK; shan.vijeratnam{at}


Objectives Unsafe opioid prescribing can lead to significant patient harm and improving standards is a national priority. This report summarises a three-stage process relating to opioid prescribing, which has led to a sustained improvement.

Methods Opioid prescriptions were reviewed retrospectively over a 4-year period in a tertiary cancer centre. The first audit cycle took place in 2017. When repeated in February 2020 following an opioid education programme implementation, prescribing remained poor. In September 2020, a quality improvement project (QIP) was developed with several interventions including opioid prescribing guidelines.

Results The first audit demonstrated that 76% met safe prescribing and 68% best practice. The second audit showed a deterioration in prescribing, 61% met safe prescribing and 39% best practice despite the implementation of an education programme. The QIP has led to an improvement in prescribing, at 4 months, 87% met safe prescribing and 56% best practice.

Conclusions Despite implementation of a medical education initiative, a marked deterioration in safe opioid prescribing occurred. A shift towards QI methodology led to a successful pilot of focused interventions and resulted in improved standards of safe prescribing.

  • service evaluation
  • education and training
  • drug administration

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors AW is responsible for the overall content as guarantor; AW, JT and DF were in charge of designing and planning of the project. SSV/JT was responsible for leading multi-disciplinary steering group to ensure QIP was carrying out in ward. SSV/JT was responsible for leading the multi-professional steering group. SSV/AW was involved with extracting data and reporting the results. AW, SSV, VP and DF contributed to the planning, outline and first draft a well as editing of paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.