Challenges of opioid deprescribing and factors to be considered in the development of opioid deprescribing guidelines: a qualitative analysis
| Autor: | Carl R. Schneider, Fiona M. Blyth, Lisa Bero, Aili V. Langford, Chung-Wei Christine Lin, Jonathan Penm, Danijela Gnjidic |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry Attitude of Health Personnel Health Policy Australia International health Focus group Analgesics Opioid 03 medical and health sciences 0302 clinical medicine Deprescriptions 030502 gerontology Intervention (counseling) Family medicine Cohort Medicine Humans 030212 general & internal medicine Prospective Studies Deprescribing Thematic analysis 0305 other medical science business Psychosocial Qualitative research |
| Zdroj: | BMJ qualitysafety. 30(2) |
| ISSN: | 2044-5423 |
| Popis: | BackgroundChronic prescription opioid use is a major international public health issue associated with significant harms, including increased risk of hospitalisation, morbidity and death. Guidance for healthcare professionals on when and how to deprescribe or reduce opioids is required. A key step for guideline development for deprescribing pharmacotherapy is to understand the perspectives of stakeholders. The aim of this study was to explore the perspectives of healthcare professional stakeholders on the challenges associated with opioid deprescribing and factors to be considered in the development of opioid deprescribing guidelines.MethodsA qualitative study was undertaken with a purposive sample of healthcare professionals including prescribers, pharmacists and nurses. An initial cohort of participants was identified at the 2018 Australian Deprescribing Network annual meeting and two focus groups were conducted (n=20). Individual interviews were conducted with a further 11 healthcare professionals. Focus groups and interviews were audio-recorded and transcribed verbatim. Data underwent inductive thematic analysis using a phenomenological perspective.ResultsHealthcare professionals viewed opioid deprescribing as a challenge and identified several key barriers to deprescribing in clinical practice. Medication, patient, prescriber and health system level challenges were identified. Participants requested evidence-based guidance on the withdrawal of opioid therapies and suggested that prospective opioid deprescribing guidelines require a multitarget, multimodal intervention strategy that addresses patient psychosocial factors and incorporates behavioural change techniques.ConclusionOpioid deprescribing was perceived as a complex and challenging practice with continued prescribing the default behaviour. Evidence-based opioid deprescribing guidelines may be a valuable resource for clinicians to support clinical decision-making and reduce suboptimal opioid use. |
| Databáze: | OpenAIRE |
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