Context

This codelist aims to: - Identify all medications prescribed as an analgesic, excluding migraine medications. - Exclude medications prescribed for other conditions

These codelists are an update of the 2018 SNOMED codelists published by Tsang et al., 2023. We created updated codes for our analysis to capture new prescriptions or codes that were changed since 2018. We chose codes the BNF system, because they are more intuitive to develop and easier to update in the future.

Search terms / synonyms / search strategy

• The analgesics prescription codelist from Tsang et al., 2023 were converted into BNF codes.
• A list of the relevant BNF chapters, sections, and paragraphs were obtained from the converted 2023 codelist (e.g. the section: analgesics, paragraph: opioid analgesics, etc).
• Medicines were matched based on their names and BNF chapter/section/paragraph
• Using the relevant BNF chapter/section/paragraph, additional medicines listed in the 2025 BNF, but not present in the 2023 codes, were identified. These were verified using an online search, and a review of primary care prescribing data on OpenPrescribing.
• Some medications in the 2023 list were removed if they were not indicated for the condition. These were verified with an online search, and a review of prescribing data on OpenPrescribing.

Inclusion/exclusion criteria

Inclusion criteria: Medications that were prescribed in primary care for pain relief, or were in the appropriate BNF chapter/section.

Exclusion criteria: Medications that were indicated for something other than pain relief, or were in other sections of the BNF (indicating that the specific item would likely be prescribed for something other than pain relief). Medications that were indicated for migraines.

Borderline cases

See: https://github.com/opensafely/codelist-development/issues/391

Additional information

For more detail on codelist development: https://github.com/opensafely/codelist-development/issues/384 Codelist underwent pharmacist review by Chris Wood