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

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    Author
    Bedford, Theresa
    Kisaalita, Nkaku
    Haycock, Nathaniel R
    Mullins, C Daniel
    Wright, Thelma
    Curatolo, Michele
    Hamlin, Lynette
    Colloca, Luana
    Date
    2022-03-24
    Type
    Article
    
    Metadata
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    See at
    https://doi.org/10.3389/fpsyt.2022.820357
    Abstract
    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.
    Rights/Terms
    Copyright © 2022 Bedford, Kisaalita, Haycock, Mullins, Wright, Curatolo, Hamlin and Colloca.
    Keyword
    chronic pain
    concealed (hidden) administration
    opioid tapering
    placebo effects
    qualitative descriptive
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18557
    ae974a485f413a2113503eed53cd6c53
    10.3389/fpsyt.2022.820357
    Scopus Count
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