Patients' perspectives on tapering programmes for prescription opioid use disorder: a qualitative study

Lisa Eveline Maria Davies; Ellen S Koster; Katinka Fm Damen; Harmen Beurmanjer; Vivienne Wt van Dam; Marcel L Bouvy; Arnt Fa Schellekens

doi:10.1136/bmjopen-2023-075246

Patients' perspectives on tapering programmes for prescription opioid use disorder: a qualitative study

Lisa Eveline Maria Davies^*, Ellen S Koster, Katinka Fm Damen, Harmen Beurmanjer, Vivienne Wt van Dam, Marcel L Bouvy, Arnt Fa Schellekens

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: Approximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients' experiences with tapering programmes for prescription OUD could help improve such programmes. Therefore, we investigated the perspectives of chronic pain patients with prescription OUD to identify facilitators and barriers to initiate and complete a specialised OUD tapering programme.

DESIGN: A qualitative study using semi-structured interviews on experiences with initiation and completion of opioid tapering was audio recorded, transcribed and subject to directed content analysis.

SETTING: This study was conducted in two facilities with specialised opioid tapering programmes in the Netherlands.

PARTICIPANTS: Twenty-five adults with chronic pain undergoing treatment for prescription OUD participated.

RESULTS: Participants indicated that tapering is a personal process, where willingness and motivation to taper, perceived (medical) support and pain coping strategies have an impact on the tapering outcome. The opportunity to join a medical-assisted tapering programme, shared decision-making regarding tapering pace, tapering location, and receiving medical and psychological support facilitated completion of an opioid tapering programme.

CONCLUSIONS: According to patients, a successful treatment of prescription OUD requires a patient-centred approach that combines personal treatment goals with shared decision-making on opioid tapering. Referral to a specialised tapering programme that incorporates opioid rotation, non-judgmental attitudes, and psychological support can create a safe and supportive environment, fostering successful tapering and recovery.

Original language	English
Article number	e075246
Pages (from-to)	1-9
Number of pages	9
Journal	BMJ Open
Volume	13
Issue number	12
DOIs	https://doi.org/10.1136/bmjopen-2023-075246
Publication status	Published - 9 Dec 2023

Bibliographical note

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.

Keywords

chronic pain
pain management
qualitative research
substance misuse

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e075246.fullFinal published version, 1.02 MBLicence: CC BY-NC

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title = "Patients' perspectives on tapering programmes for prescription opioid use disorder: a qualitative study",

abstract = "OBJECTIVES: Approximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients' experiences with tapering programmes for prescription OUD could help improve such programmes. Therefore, we investigated the perspectives of chronic pain patients with prescription OUD to identify facilitators and barriers to initiate and complete a specialised OUD tapering programme.DESIGN: A qualitative study using semi-structured interviews on experiences with initiation and completion of opioid tapering was audio recorded, transcribed and subject to directed content analysis.SETTING: This study was conducted in two facilities with specialised opioid tapering programmes in the Netherlands.PARTICIPANTS: Twenty-five adults with chronic pain undergoing treatment for prescription OUD participated.RESULTS: Participants indicated that tapering is a personal process, where willingness and motivation to taper, perceived (medical) support and pain coping strategies have an impact on the tapering outcome. The opportunity to join a medical-assisted tapering programme, shared decision-making regarding tapering pace, tapering location, and receiving medical and psychological support facilitated completion of an opioid tapering programme.CONCLUSIONS: According to patients, a successful treatment of prescription OUD requires a patient-centred approach that combines personal treatment goals with shared decision-making on opioid tapering. Referral to a specialised tapering programme that incorporates opioid rotation, non-judgmental attitudes, and psychological support can create a safe and supportive environment, fostering successful tapering and recovery.",

keywords = "chronic pain, pain management, qualitative research, substance misuse",

author = "Davies, {Lisa Eveline Maria} and Koster, {Ellen S} and Damen, {Katinka Fm} and Harmen Beurmanjer and {van Dam}, {Vivienne Wt} and Bouvy, {Marcel L} and Schellekens, {Arnt Fa}",

note = "{\textcopyright} Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Publisher Copyright: {\textcopyright} 2023 BMJ Publishing Group. All rights reserved.",

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AU - Davies, Lisa Eveline Maria

AU - Koster, Ellen S

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AU - Beurmanjer, Harmen

AU - van Dam, Vivienne Wt

AU - Bouvy, Marcel L

AU - Schellekens, Arnt Fa

N1 - © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Publisher Copyright: © 2023 BMJ Publishing Group. All rights reserved.

PY - 2023/12/9

Y1 - 2023/12/9

N2 - OBJECTIVES: Approximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients' experiences with tapering programmes for prescription OUD could help improve such programmes. Therefore, we investigated the perspectives of chronic pain patients with prescription OUD to identify facilitators and barriers to initiate and complete a specialised OUD tapering programme.DESIGN: A qualitative study using semi-structured interviews on experiences with initiation and completion of opioid tapering was audio recorded, transcribed and subject to directed content analysis.SETTING: This study was conducted in two facilities with specialised opioid tapering programmes in the Netherlands.PARTICIPANTS: Twenty-five adults with chronic pain undergoing treatment for prescription OUD participated.RESULTS: Participants indicated that tapering is a personal process, where willingness and motivation to taper, perceived (medical) support and pain coping strategies have an impact on the tapering outcome. The opportunity to join a medical-assisted tapering programme, shared decision-making regarding tapering pace, tapering location, and receiving medical and psychological support facilitated completion of an opioid tapering programme.CONCLUSIONS: According to patients, a successful treatment of prescription OUD requires a patient-centred approach that combines personal treatment goals with shared decision-making on opioid tapering. Referral to a specialised tapering programme that incorporates opioid rotation, non-judgmental attitudes, and psychological support can create a safe and supportive environment, fostering successful tapering and recovery.

AB - OBJECTIVES: Approximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients' experiences with tapering programmes for prescription OUD could help improve such programmes. Therefore, we investigated the perspectives of chronic pain patients with prescription OUD to identify facilitators and barriers to initiate and complete a specialised OUD tapering programme.DESIGN: A qualitative study using semi-structured interviews on experiences with initiation and completion of opioid tapering was audio recorded, transcribed and subject to directed content analysis.SETTING: This study was conducted in two facilities with specialised opioid tapering programmes in the Netherlands.PARTICIPANTS: Twenty-five adults with chronic pain undergoing treatment for prescription OUD participated.RESULTS: Participants indicated that tapering is a personal process, where willingness and motivation to taper, perceived (medical) support and pain coping strategies have an impact on the tapering outcome. The opportunity to join a medical-assisted tapering programme, shared decision-making regarding tapering pace, tapering location, and receiving medical and psychological support facilitated completion of an opioid tapering programme.CONCLUSIONS: According to patients, a successful treatment of prescription OUD requires a patient-centred approach that combines personal treatment goals with shared decision-making on opioid tapering. Referral to a specialised tapering programme that incorporates opioid rotation, non-judgmental attitudes, and psychological support can create a safe and supportive environment, fostering successful tapering and recovery.

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KW - pain management

KW - qualitative research

KW - substance misuse

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JO - BMJ Open

JF - BMJ Open

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M1 - e075246

ER -

Patients' perspectives on tapering programmes for prescription opioid use disorder: a qualitative study

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