BetaHCF Case Studies Library is in beta. We're still adding campaigns and fixing things.
HCF Case Studies Library

← All campaigns · Open in the library

leeds.ac.uk

Campaign to Reduce Opioid Prescribing (CROP, "Think Twice")

Also: CROP · Think Twice

“Think twice”

From April 2016 to March 2017, 316 general practices in West Yorkshire and the wider Yorkshire and Humber region got bimonthly reports comparing their opioid prescribing with other practices, with persuasive messages urging GPs to "think twice" before starting opioids and to review patients not benefiting. Run by NHS Bradford Districts CCG's West Yorkshire Research and Development team with the University of Leeds.

Years
2016–2017
Country
United Kingdom
Topic
Opioids
Asks people to
Stop
Strategy
Simple instructionSocial norms
Channel
Clinical settingDirect mail
Audience
Clinicians
General practitioners and practice teams in 316 primary care practices (2.2 million residents).

Evidence

Quasi-experimentalPositive

Controlled interrupted time series, 316 intervention vs 130 control practices (Alderson 2021): adults prescribed any opioid fell by 0.11 per 1,000 per month during the intervention year while rising 0.54 in controls - a difference of 0.65 per 1,000, about 15,000 fewer patients on opioids. Strong-opioid and high-risk-group prescribing also fell, with no rise in musculoskeletal referrals. Effects weakened after feedback stopped. University of Leeds estimated a net NHS saving of about GBP 700,000.

Sponsor (who paid)

  • NHS Bradford Districts Clinical Commissioning Group (West Yorkshire Research and Development) Foreign government, delivered the feedback
  • University of Leeds Academic, design and evaluation

Credits (who made it)

Not recorded yet.

Sources

  1. Alderson SL, Farragher TM, Willis TA et al. The effects of an evidence- and theory-informed feedback intervention on opioid prescribing for non-cancer pain in primary care: A controlled interrupted time series analysis. PLoS Med 18(10):e1003796 evaluation · 2021 · DOI 10.1371/journal.pmed.1003796 · PMID 34606504
  2. 'Think twice' to reduce risk of UK opioid epidemic (University of Leeds, 4 Oct 2021) news · 2021
  3. 'Think Twice' campaign cuts unnecessary opioid prescribing for thousands of patients (Pharmaceutical Journal) news · 2021

Research notes

Clinician-facing campaign. Discovered 2026-10-22 (clinician-campaigns pass). Fetched 2026-10-22: PMC full text (intervention 1 April 2016 to 31 March 2017), Leeds release (partners: Leeds, Manchester, NHS Bradford Districts CCG), Pharmaceutical Journal. A later replication in North East and North Cumbria (Health Innovation NENC CROP report) was found in search but the PDF returned 403. sponsor.type foreign-government used for an NHS commissioning body.

Record cases/uk-campaign-to-reduce-opioid-prescribing.json, updated 2026-10-22· Link to this campaign