Skip to main content

Research Repository

Advanced Search

Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study

Woodcock, Charlotte; Cornwall, Nicola; Dikomitis, Lisa; Harrisson, Sarah A; White, Simon; Helliwell, Toby; Knaggs, Roger; Hodgson, Eleanor; Pincus, Tamar; Santer, Miriam; Mallen, Christian; Ashworth, Julie; Jinks, Clare

Authors

Lisa Dikomitis

Roger Knaggs

Eleanor Hodgson

Tamar Pincus

Miriam Santer



Abstract

Background Opioids are frequently prescribed for persistent non-cancer pain despite limited evidence of long-term effectiveness and risk of harm. Evidence-based interventions to address inappropriate opioid prescribing are lacking.

Aim To explore perspectives of people living with persistent pain to understand barriers and facilitators in reducing opioids in the context of a pharmacist-led primary care review, and identify review components and features for optimal delivery.

Design & setting Primary care multi-method qualitative study.

Method Adults with experience of persistent pain and taking opioids participated in semi-structured interviews (n=15, 73% female) and an online discussion forum (n=31). The Theoretical Domains Framework (TDF) provided a framework for data collection and thematic analysis, involving deductive analysis to TDF domains, inductive analysis within-domains to generate subthemes, and subtheme comparison to form across-domain overarching themes. The behaviour change technique taxonomy v.1 and motivational behaviour change technique classification system were used to systematically map themes to behaviour change techniques to identify potential review components and delivery features.

Results 32 facilitator and barrier subthemes for patients reducing opioids were identified across 13 TDF domains. These combined into six overarching themes: learning to live with pain, opioid reduction expectations, assuming a medical model, pharmacist-delivered reviews, pharmacist-patient relationship and patient engagement. Subthemes mapped to 21 unique behaviour change techniques, yielding 17 components and five delivery features for the proposed PROMPPT review.

Conclusion This study generated theoretically-informed evidence for design of a practice pharmacist-led PROMPPT review. Future research will test the feasibility and acceptability of the PROMPPT review and pharmacist training.

Citation

Woodcock, C., Cornwall, N., Dikomitis, L., Harrisson, S. A., White, S., Helliwell, T., …Jinks, C. (2024). Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study. British Journal of General Practice Open (BJGP Open), Article BJGPO.2023.0221. https://doi.org/10.3399/BJGPO.2023.0221

Journal Article Type Article
Acceptance Date Mar 26, 2024
Online Publication Date Apr 17, 2024
Publication Date Apr 17, 2024
Deposit Date Apr 22, 2024
Journal BJGP Open
Print ISSN 2398-3795
Electronic ISSN 2398-3795
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Article Number BJGPO.2023.0221
DOI https://doi.org/10.3399/BJGPO.2023.0221
Keywords Pharmacists, Chronic pain, Opioid analgesic
Public URL https://keele-repository.worktribe.com/output/796820