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Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives

Standard opioid tapers tend to be associated with increased patient anxiety and higher pain ratings. Pre-authorized concealed opioid reductions may minimize expectations such as fear of increased pain due to the reduction of opioids and, prolong analgesic benefits in experimental settings. We recent...

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Autores principales: Bedford, Theresa, Kisaalita, Nkaku, Haycock, Nathaniel R., Mullins, C. Daniel, Wright, Thelma, Curatolo, Michele, Hamlin, Lynette, Colloca, Luana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8987573/
https://www.ncbi.nlm.nih.gov/pubmed/35401245
http://dx.doi.org/10.3389/fpsyt.2022.820357
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author Bedford, Theresa
Kisaalita, Nkaku
Haycock, Nathaniel R.
Mullins, C. Daniel
Wright, Thelma
Curatolo, Michele
Hamlin, Lynette
Colloca, Luana
author_facet Bedford, Theresa
Kisaalita, Nkaku
Haycock, Nathaniel R.
Mullins, C. Daniel
Wright, Thelma
Curatolo, Michele
Hamlin, Lynette
Colloca, Luana
author_sort Bedford, Theresa
collection PubMed
description Standard opioid tapers tend to be associated with increased patient anxiety and higher pain ratings. Pre-authorized concealed opioid reductions may minimize expectations such as fear of increased pain due to the reduction of opioids and, prolong analgesic benefits in experimental settings. We recently observed that patients and clinicians are open to concealed opioid tapering. However, little is known about the “why” behind their attitudes. Based on this lack of data, we analyzed qualitative responses to survey questions on patients' and clinicians' acceptance of a concealed opioid reduction for chronic pain. Seventy-four patients with a history of high dose opioid therapy and 49 clinicians completed a web-based questionnaire with open-ended questions examining responses to two hypothetical clinical trials comparing a concealed opioid reduction pre-authorized by patients vs. standard tapering. We used content analysis based on qualitative descriptive methodology to analyze comments from the patients and clinicians. Five themes were identified: informed consent; anxiety; safety; support; and ignorance is bliss, or not. These themes highlight the overall positive attitudes toward concealed opioid tapers. Our findings reinforce the importance of patient-centered care and are expected to inform the design of clinical trials from both the patient and clinician perspective. This qualitative study presents patients' and clinicians' attitudes toward hypothetical scenarios for a trial of pre-authorized reduction of opioids. The findings indicate positive attitudes and the relevance of engaging patients with effective decision-making processes.
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spelling pubmed-89875732022-04-08 Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives Bedford, Theresa Kisaalita, Nkaku Haycock, Nathaniel R. Mullins, C. Daniel Wright, Thelma Curatolo, Michele Hamlin, Lynette Colloca, Luana Front Psychiatry Psychiatry Standard opioid tapers tend to be associated with increased patient anxiety and higher pain ratings. Pre-authorized concealed opioid reductions may minimize expectations such as fear of increased pain due to the reduction of opioids and, prolong analgesic benefits in experimental settings. We recently observed that patients and clinicians are open to concealed opioid tapering. However, little is known about the “why” behind their attitudes. Based on this lack of data, we analyzed qualitative responses to survey questions on patients' and clinicians' acceptance of a concealed opioid reduction for chronic pain. Seventy-four patients with a history of high dose opioid therapy and 49 clinicians completed a web-based questionnaire with open-ended questions examining responses to two hypothetical clinical trials comparing a concealed opioid reduction pre-authorized by patients vs. standard tapering. We used content analysis based on qualitative descriptive methodology to analyze comments from the patients and clinicians. Five themes were identified: informed consent; anxiety; safety; support; and ignorance is bliss, or not. These themes highlight the overall positive attitudes toward concealed opioid tapers. Our findings reinforce the importance of patient-centered care and are expected to inform the design of clinical trials from both the patient and clinician perspective. This qualitative study presents patients' and clinicians' attitudes toward hypothetical scenarios for a trial of pre-authorized reduction of opioids. The findings indicate positive attitudes and the relevance of engaging patients with effective decision-making processes. Frontiers Media S.A. 2022-03-24 /pmc/articles/PMC8987573/ /pubmed/35401245 http://dx.doi.org/10.3389/fpsyt.2022.820357 Text en Copyright © 2022 Bedford, Kisaalita, Haycock, Mullins, Wright, Curatolo, Hamlin and Colloca. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Bedford, Theresa
Kisaalita, Nkaku
Haycock, Nathaniel R.
Mullins, C. Daniel
Wright, Thelma
Curatolo, Michele
Hamlin, Lynette
Colloca, Luana
Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives
title Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives
title_full Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives
title_fullStr Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives
title_full_unstemmed Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives
title_short Attitudes Toward a Pre-authorized Concealed Opioid Taper: A Qualitative Analysis of Patient and Clinician Perspectives
title_sort attitudes toward a pre-authorized concealed opioid taper: a qualitative analysis of patient and clinician perspectives
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8987573/
https://www.ncbi.nlm.nih.gov/pubmed/35401245
http://dx.doi.org/10.3389/fpsyt.2022.820357
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