Article Figures & Data
Tables
- Table 1. Categorisation of patients by opioid strength based on a hierarchy of analgesic potency arising from a consensus study of UK GPs23
Weak Intermediate Strong Co-codamol 8 mg/500 mg Codeine 30 mg Morphine Co-codamol 15 mg/500 mg Co-codamol 30 mg/500 mg Oxycodone Codeine 15 mg Dihydrocodeine 30 mg Fentanyl Codeine 20 mg Buprenorphine patch ≥15 mcg/hour Tapentadol Co-dydramol 10 mg/500 mg Buprenorphine sublingual 400 mcg Diamorphine Co-dydramol 20 mg/500 mg Tramadol >37.5 mg Hydromorphone Dihydrocodeine 20 mg Pethidine Dipipanone Co-proxamol 32.5 mg/325 mg Pentazocine Dextromoramide Tramadol 37.5 mg/500 mg Meptazinol Buprenorphine patch 5 or 10 mcg/hour Buprenorphine sublingual 200 mcg - Table 2. Participant demographics of people living with persistent non-cancer pain (n = 15 interviews)
Opioid strength Total Sex Age range (mean) years Weak Intermediate Strong Male 55–83 (68.75) 1 1 2 4 Female 54–87 (70.73) 2 4 5 11 All 54–87 (70.20) 3 5 7 15 Opioid strength based on published categorisation for prescribed analgesics in primary care.23
- Table 3. TDF domains, facilitator and barrier sub-themes, and overarching themes for patients reducing opioids in the context of a PROMPPT review
TDF domain Sub-theme Fa Bb Overarching theme Knowledge Knowing about and managing pain ✓ ✓ Learning to live with pain Behavioural regulation Self-regulating pain management ✓ ✓ Environmental context and resources Accessible evidence-based resources ✓ Social influences Social support ✓ ✓ Social or professional role and identity Changing identities ✓ ✓ Goals Live better with pain ✓ Knowledge Knowing about reducing opioids ✓ ✓ Opioid reduction expectations Behavioural regulation Monitoring for quick effectiveness of opioid reduction ✓ ✓ Beliefs about capabilities Unable to cope with an opioid reduction ✓ Beliefs about consequences Consequences of reducing opioids ✓ ✓ Intentions Intention to reduce ✓ ✓ Emotions Anxious about reducing opioids ✓ Reinforcement Avoid withdrawal ✓ Reduce if potential benefits perceived ✓ Social influences Prescribed by healthcare professional ✓ Assuming a medical model Reinforcement Opioids are necessary ✓ Left on repeat prescription ✓ Knowledge Pharmacist knowing about and managing pain within primary care ✓ Pharmacist-delivered reviews Skills Patient-centred shared decision making ✓ Social influences Patient–clinician relationship ✓ ✓ Pharmacist–patient relationship Supportive point of contact for pain management ✓ Knowledge Patient knowledge of PROMPPT review ✓ Patient engagement Environmental context and resources Accessibility of a PROMPPT review ✓ ✓ Beliefs about capabilities Able to discuss experiences of pain, medicines, and management ✓ Beliefs about consequences Wide-ranging benefits ✓ PROMPPT review concerns ✓ Provide a pharmacological solution ✓ Intentions Intention to engage in a PROMPPT review ✓ ✓ Goals Find a pharmacological solution ✓ Increase understanding of pain and medicines ✓ Optimism Optimistic a PROMPPT review will be helpful ✓ Uncertain of personal relevancy of a PROMPPT review ✓ aF = facilitator. bB = barrier.
Supplementary Data
- CW_10.3399BJGPO.2023.0221_supp.pdf -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
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Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study
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