Patient perceptions of long-term opioid prescribing

• Research type

  Research Study

• Full title

  Long-term use of prescription opioid medicines in primary care – A qualitative study

• IRAS ID

  244498

• Contact name

  Glenys Caswell

• Contact email

  glenys.caswell@nottingham.ac.uk

• Sponsor organisation

  University of Nottingham

• Duration of Study in the UK

  0 years, 2 months, 17 days

• Research summary

  The Clinical Practice Research Database, shows one in twenty patients, prescribed opioid medicines. Guidance for prescribing opioid medicines in non-cancer pain highlight that Where agreed outcomes in pain reduction are not met, the dose should be tapered down and alternative strategies considered. The NHS promotes the principle of shared decision making and requires that clinical decisions be consistent with the preferences and values of the patient. A qualitative insight into the patient journey to long-term opioid prescribing and the interventions used to manage opioid prescriptions will be valuable to informing this process and identifying areas for research.

  Research question:
  To gain an understanding of the factors associated with long-term prescribing of opioid medicines in Primary Care and the interventions used to manage this.

  Objectives:
  •To identify patient perceptions of factors leading to high dose long-term prescribing of opioid medicines
  •To identify patient perceptions of the interventions used to manage high dose long-term prescribing of opioid medicines.
  •To identify common factors associated with high dose prescribing of long-term opioid medicines and the interventions recommended to manage this.

  Design
  Semi-structured interviews with up to 8 patients prescribed long term opioid medicines. Interviews will last up to 1 hour. Patients will be recruited from GP practices in Nottingham North and East CCG.

  Inclusion criteria:
  • Participant willing and able to give informed consent for participation in the project.
  • Male or Female, aged 18 years or above.
  • Patients prescribed high dose opioid medicines at a dose equivalent to or greater than 120mg morphine equivalent.
  • The patient and prescriber have worked to reduce the dose of prescribed opioid medicine
  • Participant able to communicate in English

  Exclusion criteria:
  •Severe and enduring mental health problems, where the patient has current contact with secondary care mental health services.
  •Diagnosed with cancer
  •Prescribed opioid medicines secondary to illicit drugs or alcohol
  •Unable to give informed consent

  Interviews will be recorded and transcribed. Thematic analysis will be used to analyse data.

• REC name

  East Midlands - Nottingham 2 Research Ethics Committee

• REC reference

  18/EM/0142

• Date of REC Opinion

  9 Jul 2018

• REC opinion

  Further Information Favourable Opinion