Prescription Opioid Decision-making and Use Behaviors in Adolescents With Acute Pain: A Qualitative Study.

Autor:	Kapos FP; Center for Child Health, Behavior and Development.; Department of Orthopaedic Surgery.; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC., Gordon GO; Center for Clinical and Translational Research, Seattle Children's Research Institute.; College of Arts and Sciences., Groenewald CB; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA., Slack K; Elson S. Floyd College of Medicine, Washington State University, Spokane, WA., Wang V; Center for Clinical and Translational Research, Seattle Children's Research Institute.; College of Arts and Sciences.; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA., Palermo TM; Center for Child Health, Behavior and Development.; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle., Wilson AC; Department of Pediatrics, Oregon Health & Science University, Portland, OR., Rabbitts JA; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA.
Jazyk:	angličtina
Zdroj:	The Clinical journal of pain [Clin J Pain] 2024 Jun 01; Vol. 40 (6), pp. 333-340. Date of Electronic Publication: 2024 Jun 01.
DOI:	10.1097/AJP.0000000000001205
Abstrakt:	Objectives: Understanding adolescent perspectives on prescribed opioids in the context of medical care for acute pain is needed to prevent opioid-related adverse outcomes. We explored factors that may influence opioid decision-making and use behaviors among adolescents prescribed opioids for acute pain. Methods: We conducted semistructured interviews with 19 adolescents (63% females, ages 12 to 17) prescribed opioids upon discharge from surgery or intensive care unit admission. Interview transcripts were coded using inductive thematic analysis. Results: Five themes were identified: "Opioid use to reduce extreme pain and facilitate acute recovery"; "Familiarity with risks and negative effects of opioids"; "Assessment of opioid risk based on individual characteristics and use behaviors"; "Careful balance of risks, benefits, and symptoms when taking opioids"; "Importance of trusted adults for adolescent opioid management". Adolescents commonly believe opioids are only appropriate for severe pain that cannot be managed with other strategies. Most (but not all) adolescents were aware of addiction and other potential opioid harms and generally disapproved of misuse. However, a few adolescents would consider taking unprescribed opioids for severe pain. Adolescents wanted to be well informed for opioid decision-making, considering guidance from trusted adults. Discussion: Adolescents often demonstrated active and sound participation in shared opioid decision-making, influenced by complex integration of inputs and self-reflection. Conversely, potential factors that could contribute to risky behaviors included low personal risk perceptions, uncertainty about what constitutes opioid misuse, and avoidance of prescribed opioids despite extreme pain. Future studies may explore associations of adolescents' opioid decision-making with longer-term pain and opioid-related outcomes. Competing Interests: F.P.K. received a travel award from the US Association for the Study of Pain (USASP) to present an earlier version of this work at the USASP 2023 Annual Scientific Meeting. The remaining authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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