PDF(Pubmed)
Abstract：
BACKGROUND: Over the past decade, long-term use of prescription opioids for chronic non-cancer pain has risen globally despite the associated risks. Most opioid users receive their first prescription in primary care.
OBJECTIVE: To investigate the perspective of patients who are long-term opioid users in primary care regarding the role of healthcare providers (HCPs) in their prolonged opioid use.
METHODS: Semi-structured interviews in Dutch primary care.
METHODS: We recruited patients who were long-term users of opioids for chronic non-cancer pain from seven community pharmacies in the Netherlands. In-depth, semi-structured interviews focused on patients\' experiences with long-term opioid use, access to opioids, and the guidance of their HCPs (primarily their GPs and pharmacists). A directed content analysis was conducted on the transcribed interviews using NVivo.
RESULTS: Participants (n = 25) described ways in which HCPs impacted their long-term use of opioids. These encompassed the initiation of treatment, chronic use of opioids, and discontinuation of treatment. Participants stressed the need for risk counselling during initial prescribing, ongoing medication evaluations including tapering conversations, and more support from their HCP during a tapering attempt.
CONCLUSIONS: Patients\' perspectives illustrate the important role of HCPs across the spectrum of opioid use - from initiation to tapering. The results of this study underscore the importance of clear risk counselling starting at initial prescribing, repeated medication assessments throughout treatment, addressing tapering at regular intervals, and strong support during tapering. These insights carry significant implications for clinical practice, emphasising the importance of informed and patient-centred care when it comes to opioid use for chronic non-cancer pain management.
OBJECTIVE: To investigate the perspective of patients who are long-term opioid users in primary care regarding the role of healthcare providers (HCPs) in their prolonged opioid use.
METHODS: Semi-structured interviews in Dutch primary care.
METHODS: We recruited patients who were long-term users of opioids for chronic non-cancer pain from seven community pharmacies in the Netherlands. In-depth, semi-structured interviews focused on patients\' experiences with long-term opioid use, access to opioids, and the guidance of their HCPs (primarily their GPs and pharmacists). A directed content analysis was conducted on the transcribed interviews using NVivo.
RESULTS: Participants (n = 25) described ways in which HCPs impacted their long-term use of opioids. These encompassed the initiation of treatment, chronic use of opioids, and discontinuation of treatment. Participants stressed the need for risk counselling during initial prescribing, ongoing medication evaluations including tapering conversations, and more support from their HCP during a tapering attempt.
CONCLUSIONS: Patients\' perspectives illustrate the important role of HCPs across the spectrum of opioid use - from initiation to tapering. The results of this study underscore the importance of clear risk counselling starting at initial prescribing, repeated medication assessments throughout treatment, addressing tapering at regular intervals, and strong support during tapering. These insights carry significant implications for clinical practice, emphasising the importance of informed and patient-centred care when it comes to opioid use for chronic non-cancer pain management.
摘要：
背景：在过去的十年中，尽管存在相关风险,但长期使用处方阿片类药物治疗慢性非癌性疼痛(CNCP)的情况在全球范围内有所上升.大多数阿片类药物使用者在初级保健中获得了他们的第一个处方。
目的：调查初级保健长期阿片类药物使用者对医疗保健提供者（HCP）在长期阿片类药物使用中的作用的看法。
方法：荷兰初级保健的半结构化访谈方法：我们从荷兰的七个社区药房招募了CNCP的长期阿片类药物使用者。深入,半结构化访谈侧重于长期使用阿片类药物的经验，获得阿片类药物，以及他们的HCPs的指导。使用NVivo对转录访谈进行了定向内容分析。
结果：参与者（n=25）提到了HCP影响其长期使用阿片类药物的方式。这些包括：1）开始治疗，2）长期使用阿片类药物，（3）停止治疗。与会者强调在初始处方期间需要进行风险咨询，正在进行的药物评估，包括逐渐减少的对话，在逐渐缩小的尝试中，他们的HCP会提供更多支持。
结论：患者的观点说明了HCP在阿片类药物使用范围内的重要作用-从开始到逐渐减少。它强调了从最初的处方开始明确风险咨询的重要性，在整个治疗过程中进行持续的药物评估，定期解决逐渐变细问题，并在逐渐变细过程中提供强有力的支持。这些见解对临床实践具有重要意义，强调在慢性非癌性疼痛管理中使用阿片类药物时，以知情和以患者为中心的护理的重要性。
目的：调查初级保健长期阿片类药物使用者对医疗保健提供者（HCP）在长期阿片类药物使用中的作用的看法。
方法：荷兰初级保健的半结构化访谈方法：我们从荷兰的七个社区药房招募了CNCP的长期阿片类药物使用者。深入,半结构化访谈侧重于长期使用阿片类药物的经验，获得阿片类药物，以及他们的HCPs的指导。使用NVivo对转录访谈进行了定向内容分析。
结果：参与者（n=25）提到了HCP影响其长期使用阿片类药物的方式。这些包括：1）开始治疗，2）长期使用阿片类药物，（3）停止治疗。与会者强调在初始处方期间需要进行风险咨询，正在进行的药物评估，包括逐渐减少的对话，在逐渐缩小的尝试中，他们的HCP会提供更多支持。
结论：患者的观点说明了HCP在阿片类药物使用范围内的重要作用-从开始到逐渐减少。它强调了从最初的处方开始明确风险咨询的重要性，在整个治疗过程中进行持续的药物评估，定期解决逐渐变细问题，并在逐渐变细过程中提供强有力的支持。这些见解对临床实践具有重要意义，强调在慢性非癌性疼痛管理中使用阿片类药物时，以知情和以患者为中心的护理的重要性。
