Author:
Seangrung Rattaphol,Tempeetikul Thongchai,Pannarunothai Supasit,Sakdanuwatwong Supalak
Abstract
Abstract
Background
Opioids are currently prescribed for chronic non-cancer pain (CNCP), and some patients use opioids continuously for long-term treatment. Stakeholders’ awareness about long-term opioid therapy is essential for improving the safety and effectiveness of pain treatment. The purpose of this study is to explore the perspectives of pain specialists, patients, and family caregivers about long-term opioid use in CNCP management.
Methods
This study was a qualitative study and adhered to the COREQ guidelines. Pain specialists (n = 12), patients (n = 14), and family members (n = 9) were recruited to the study by purposive sampling at the Pain Clinic of Ramathibodi Hospital. Semi-structured interviews were recorded, verbatim transcribed, conceptually coded, and analyzed using Atlas.ti 8.0.
Results
All groups of participants described opioids as non-first-line drugs for pain management. Opioids should be prescribed only for severe pain, when non-opioid pharmacotherapy and non-pharmacological therapies are not effective. Patients reported that the benefits of opioids were for pain relief, while physicians and most family members highlighted that opioid use should improve functional outcomes. Physicians and family members expressed concerns about opioid-related side effects, harm, and adverse events, while patients did not. Patients confirmed that they would continue using opioids for pain management under supervision. However, physicians stated that they would taper off or discontinue opioid therapy if patients’ pain relief or functional improvement was not achieved. Both patients and family members were willing to consider non-pharmacological therapies if potential benefits existed. Patient education, doctor–patient/family relationships, and opioid prescription policies were proposed to enhance CNCP management.
Conclusion
Long-term opioid therapy for CNCP may be beneficial in patients who have established realistic treatment goals (for both pain relief and functional improvement) with their physicians. Regular monitoring and evaluation of the risks and benefits, adverse events, and drug-related aberrant behaviors are necessary. Integrated multimodal multidisciplinary therapies and family member collaborations are also important for improving CNCP management.
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine
Reference47 articles.
1. Hogan ME, Taddio A, Katz J, et al. Health utilities in people with chronic pain using a population-level survey and linked health care administrative data. Pain. 2017;158:408–16.
2. Mohamed Zaki LR, Hairi NN. A systematic review of the prevalence and measurement of chronic pain in Asian adults. Pain Manag Nurs. 2015;16:440–52.
3. Knodel J, Teerawichitchainan B, Prachuabmoh V, Pothisiri W. The Situation of Thailand’s Older Population an Update Based on the 2014 Survey of Older Persons in Thailand. 2014.. Available from: http://www.psc.isr.umich.edu/pubs/pdf/rr15-847.pdf. Accessed 1 May 2020.
4. Sakakibara T, Wang Z, Paholpak P, Kosuwon W, Oo M, Kasai Y. A comparison of chronic pain prevalence in Japan, Thailand, and Myanmar. Pain Physician. 2013;16:603–8.
5. Cheung CW, Choo CY, Kim Y-C, et al. Inadequate management of chronic non-cancer pain and treatment-related adverse events in Asia: perspectives from patients from 10 countries/regions. SN Compr Clin Med. 2019;1:442–50.
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