Literature DB >> 33616160

"We Need to Taper." Interviews with Clinicians and Pharmacists About Use of a Pharmacy-Led Opioid Tapering Program.

Alison J Firemark1, Jennifer L Schneider1, Jennifer L Kuntz1, Dea Papajorgji-Taylor1, John F Dickerson1, Lou Ann Thorsness2, Katherine R Reese2, Mark D Sullivan3, Lynn L Debar4, David H Smith1.   

Abstract

OBJECTIVE: To identify factors that influence or interfere with referrals by primary care providers (PCPs) to a pharmacist-led telephone-based program to assist patients undergoing opioid tapering. The Support Team Onsite Resource for Management of Pain (STORM) program provides individualized patient care and supports PCPs in managing opioid tapers.
DESIGN: Qualitative interviews were conducted with referring PCPs and STORM staff. Interview guides addressed concepts from the RE-AIM framework, focusing on issues affecting referral to the STORM program.
SETTING: An integrated healthcare system (HCS) in the Northwest United States.
SUBJECTS: Thirty-five interviews were conducted with 20 PCPs and 15 STORM staff.
METHODS: Constant comparative analysis was used to identify key themes from interviews. A codebook was developed based on interview data and a qualitative software program was used for coding, iterative review, and content analysis. Representative quotes illustrate identified themes.
RESULTS: Use of the STORM opioid tapering program was influenced by PCP, patient, and HCS considerations. Factors motivating use of STORM included lack of PCP time to support chronic pain patients requiring opioid tapering and the perception that STORM is a valued partner in patient care. Impediments to referral included PCP confidence in managing opioid tapering, patient resistance to tapering, forgetting about program availability, and PCP resistance to evolving guidelines regarding opioid tapering goals.
CONCLUSIONS: PCPs recognized that STORM supported patient safety and reduced clinician burden. Utilization of the program could be improved through ongoing PCP education about the service and consistent co-location of STORM pharmacists within primary care clinics.
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Entities:  

Keywords:  Chronic Pain; Opioid Tapering; Pharmacy; Qualitative; Referral

Mesh:

Substances:

Year:  2021        PMID: 33616160      PMCID: PMC8139822          DOI: 10.1093/pm/pnaa442

Source DB:  PubMed          Journal:  Pain Med        ISSN: 1526-2375            Impact factor:   3.750


  30 in total

1.  Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective.

Authors:  Laxmaiah Manchikanti; Bert Fellows; Hary Ailinani; Vidyasagar Pampati
Journal:  Pain Physician       Date:  2010 Sep-Oct       Impact factor: 4.965

2.  The patient-provider relationship in chronic pain care: providers' perspectives.

Authors:  Marianne S Matthias; Amy L Parpart; Kathryn A Nyland; Monica A Huffman; Dawana L Stubbs; Christy Sargent; Matthew J Bair
Journal:  Pain Med       Date:  2010-11       Impact factor: 3.750

3.  The effect of opioid dose and treatment duration on the perception of a painful standardized clinical stimulus.

Authors:  Steven P Cohen; Paul J Christo; Shuxing Wang; Lucy Chen; Milan P Stojanovic; Cynthia H Shields; Chad Brummett; Jianren Mao
Journal:  Reg Anesth Pain Med       Date:  2008 May-Jun       Impact factor: 6.288

4.  Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone.

Authors:  Irfan A Dhalla; Muhammad M Mamdani; Marco L A Sivilotti; Alex Kopp; Omar Qureshi; David N Juurlink
Journal:  CMAJ       Date:  2009-12-07       Impact factor: 8.262

5.  Taking opioids in times of crisis: Institutional oversight, chronic pain and suffering in an integrated healthcare delivery system in the U.S.

Authors:  Inga Gruß; Alison Firemark; Meghan Mayhew; Carmit K McMullen; Lynn L DeBar
Journal:  Int J Drug Policy       Date:  2019-09-16

6.  Communicating about opioids for chronic pain: a qualitative study of patient attributions and the influence of the patient-physician relationship.

Authors:  M S Matthias; E E Krebs; A A Bergman; J M Coffing; M J Bair
Journal:  Eur J Pain       Date:  2013-11-25       Impact factor: 3.931

Review 7.  A comprehensive review of opioid-induced hyperalgesia.

Authors:  Marion Lee; Sanford M Silverman; Hans Hansen; Vikram B Patel; Laxmaiah Manchikanti
Journal:  Pain Physician       Date:  2011 Mar-Apr       Impact factor: 4.965

8.  Prescription opioid analgesics increase the risk of depression.

Authors:  Jeffrey F Scherrer; Dragan M Svrakic; Kenneth E Freedland; Timothy Chrusciel; Sumitra Balasubramanian; Kathleen K Bucholz; Elizabeth V Lawler; Patrick J Lustman
Journal:  J Gen Intern Med       Date:  2013-10-29       Impact factor: 5.128

9.  "Those Conversations in My Experience Don't Go Well": A Qualitative Study of Primary Care Provider Experiences Tapering Long-term Opioid Medications.

Authors:  Laura C Kennedy; Ingrid A Binswanger; Shane R Mueller; Cari Levy; Daniel D Matlock; Susan L Calcaterra; Stephen Koester; Joseph W Frank
Journal:  Pain Med       Date:  2018-11-01       Impact factor: 3.750

Review 10.  CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016.

Authors:  Deborah Dowell; Tamara M Haegerich; Roger Chou
Journal:  JAMA       Date:  2016-04-19       Impact factor: 56.272

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  1 in total

Review 1.  Adjunct Digital Interventions Improve Opioid-Based Pain Management: Impact of Virtual Reality and Mobile Applications on Patient-Centered Pharmacy Care.

Authors:  Hayam Y Giravi; Zack Biskupiak; Linda S Tyler; Grzegorz Bulaj
Journal:  Front Digit Health       Date:  2022-06-13
  1 in total

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