Patient, family members and community pharmacists' views of a proposed overdose prevention intervention delivered in community pharmacies for patients prescribed high‐strength opioids for chronic non‐cancer pain: An explorative intervention development study

Mercer, Fiona; Parkes, Tessa; Foster, Rebecca; Steven, Deborah; McAuley, Andrew; Baldacchino, Alexander; Steele, Wez; Schofield, Joe; Matheson, Catriona

Abstract

Introduction
Despite opioid prescribing for chronic non-cancer pain (CNCP) having limited therapeutic benefits, recent evidence indicates significant increases in the prescribing of high-strength opioids for individuals with CNCP. Patients prescribed opioids for CNCP have overdose risk factors but generally have low opioid overdose awareness and low perceptions of risk related to prescribed opioids. Currently, there are few bespoke overdose prevention resources for this group.

Methods
This qualitative study investigated views on a naloxone intervention for people prescribed high-strength opioids for CNCP delivered via community pharmacies. The intervention included overdose risk awareness and naloxone training and provision. Interviews were conducted with eight patients, four family members and two community pharmacists. Participants were convenience sampled and recruited through networks within the Scottish pain community. The Framework approach was used to analyse findings.

Results
All participants had positive attitudes towards the intervention, but patients and family members considered risk of overdose to be very low. Three themes were identified: potential advantages of the intervention; potential barriers to the intervention; and additional suggestions and feedback about the intervention. Advantages included the intervention providing essential overdose information for CNCP patients. Barriers included resource and time pressures within community pharmacies.

Discussion and Conclusion
While patients had low overdose knowledge and did not see themselves as being at risk of opioid overdose, they were receptive to naloxone use and positive about the proposed intervention. A feasibility trial is merited to further investigate how the intervention would be experienced within community pharmacy settings.

Citation

Mercer, F., Parkes, T., Foster, R., Steven, D., McAuley, A., Baldacchino, A., Steele, W., Schofield, J., & Matheson, C. (2023). Patient, family members and community pharmacists' views of a proposed overdose prevention intervention delivered in community pharmacies for patients prescribed high‐strength opioids for chronic non‐cancer pain: An explorative intervention development study. Drug and Alcohol Review, 42(3), 517-526. https://doi.org/10.1111/dar.13554

• Journal Article Type: Article
• Acceptance Date: Sep 4, 2022
• Online Publication Date: Sep 27, 2022
• Publication Date: 2023-03
• Deposit Date: Sep 28, 2022
• Publicly Available Date: Sep 28, 2022
• Journal: Drug and Alcohol Review
• Print ISSN: 0959-5236
• Electronic ISSN: 1465-3362
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 42
• Issue: 3
• Pages: 517-526
• DOI: https://doi.org/10.1111/dar.13554
• Keywords: chronic non-cancer pain, naloxone, overdose intervention, overdose risk, prescription opioids
• Public URL: http://researchrepository.napier.ac.uk/Output/2925437