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. 2020 Jan 30;70(691):e120-e129.
doi: 10.3399/bjgp19X706097. Print 2020 Feb.

Acceptability of a primary care-based opioid and pain review service: a mixed-methods evaluation in England

Joanna M Kesten  1 , Kyla Thomas  2 , Lauren J Scott  3 , Kevin Bache  4 , Matthew Hickman  5 , Rona Campbell  6 , Anthony E Pickering  7 , Sabi Redwood  3
Affiliations

Acceptability of a primary care-based opioid and pain review service: a mixed-methods evaluation in England

Joanna M Kesten et al. Br J Gen Pract. .

Abstract

Background: Primary care opioid prescribing to treat chronic non-cancer pain (CNCP) has progressively increased despite a lack of evidence for long-term safety and effectiveness. Developing primary care interventions to reduce opioid dependence in patients with CNCP is a public health priority.

Aim: To report the acceptability of the South Gloucestershire pain and opioid review service for patients with CNCP, which aimed to help patients understand their relationship with prescribed opioids and support non-drug-based pain management strategies.

Design and setting: A mixed-methods evaluation was performed on the service, which was based in two GP practices in South Gloucestershire, England, and delivered by project workers.

Method: Descriptive data were collected on delivered-within-service and community-based interventions. Twenty-five semi-structured interviews (n = 18 patients, n = 7 service providers) explored experiences of the service.

Results: The enrolment process, person-centred primary care-based delivery, and service content focused on psychological issues underlying CNCP were found to be acceptable to patients and service providers. Patients welcomed having time to discuss their pain, its management, and related psychological issues. Maintaining a long-term approach was desired as CNCP is a complex issue that takes time to address. GPs recommended that funding was needed to ensure they have dedicated time to support a similar service and to ensure that project workers received adequate clinical supervision.

Conclusion: This service model was acceptable and may be a useful means to manage patients with CNCP who develop opioid dependence after long-term use of opioids. A randomised controlled trial is needed to formally test the effectiveness of the service.

Keywords: chronic pain; health promotion; opioid-related disorders; pain; pain management; primary health care.

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Figures

Figure 1.
Figure 1.
Intervention logic model. aPresented elsewhere.
Figure 2.
Figure 2.
Proportion of patients accessing within-session components. OAD = opioid analgesic dependence.
Figure 3.
Figure 3.
Proportion of patients accessing community-based services and social prescribing. OAD = opioid analgesic dependence.
See this image and copyright information in PMC

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