Evaluation of a primary care-based opioid and pain review service: a mixed-methods evaluation in two GP practices in England
| Autor: | Joanna M Kesten, Kyla H Thomas, Matthew Hickman, Rona Campbell, Lauren J Scott, Anthony E. Pickering, Kevin Bache, Sabi Redwood |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty General Practice Pain Health Promotion law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Quality of life law Interquartile range medicine Humans Pain Management 030212 general & internal medicine Practice Patterns Physicians' Service (business) Primary Health Care business.industry Editorials opioids chronic non-cancer pain Middle Aged Service provider Test (assessment) Analgesics Opioid Health promotion England Opioid Family medicine Female Chronic Pain Family Practice business 030217 neurology & neurosurgery Anaesthesia Pain and Critical Care medicine.drug |
| Zdroj: | Br J Gen Pract Scott, L J, Kesten, J, Bache, K, Hickman, M, Campbell, R, Pickering, A E, Redwood, S & Thomas, K 2019, ' Evaluation of a primary care-based opioid and pain review service : a mixed-methods evaluation in two GP practices in England ', British Journal of General Practice . https://doi.org/10.3399/bjgp19X707237 |
| ISSN: | 1478-5242 0960-1643 |
| Popis: | Background Opioid prescribing to treat chronic non-cancer pain has rapidly increased, despite a lack of evidence for long-term safety and effectiveness. A pain review service was developed to work with patients taking opioids long-term to explore opioid use, encourage non-drug-based alternatives, and, where appropriate, support dose reduction.Aim To evaluate the service and its potential impact on opioid use, health and wellbeing outcomes, and quality of life (QoL).Design and setting Mixed-methods evaluation of a one-to-one service based in two GP practices in South Gloucestershire, England, which took place from September 2016 to December 2017.Method Quantitative data were collected on baseline demographics; data on opioid use, misuse, and dose, health, wellbeing, QoL, and pain and interference with life measures were collected at baseline and follow-up. Twenty-five semi-structured interviews (n = 18 service users, n = 7 service providers) explored experiences of the service including perceived impacts and benefits.Results Of 59 patients who were invited, 34 (57.6%) enrolled in the service. The median prescribed opioid dose reduced from 90 mg (average daily morphine equivalent; interquartile range [IQR] 60 to 240) at baseline to 72 mg (IQR 30 to 160) at follow-up (PConclusion The service was well received, and health and wellbeing outcomes suggest a potential benefit. Following further service development, a randomised controlled trial to test this type of care pathway is warranted. |
| Databáze: | OpenAIRE |
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