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Research

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

Joanna M Kesten, Kyla Thomas, Lauren J Scott, Kevin Bache, Matthew Hickman, Rona Campbell, Anthony E Pickering and Sabi Redwood
British Journal of General Practice 2020; 70 (691): e120-e129. DOI: https://doi.org/10.3399/bjgp19X706097
Joanna M Kesten
NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) West, University Hospitals Bristol NHS Foundation Trust; NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol.
Roles: Senior research associate in social science qualitative research
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Kyla Thomas
Population Health Sciences, Bristol Medical School, University of Bristol; South Gloucestershire Council, Bristol.
Roles: Consultant senior lecturer in public health medicine
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Lauren J Scott
NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.
Roles: Senior research associate in quantitative applied health research
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Kevin Bache
Developing Health and Independence, Bristol.
Roles: OAD coordinator
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Matthew Hickman
Population Health Sciences, Bristol Medical School; NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol.
Roles: Professor in public health and epidemiology
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Rona Campbell
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.
Roles: Professor of public health research
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Anthony E Pickering
Department of Anaesthesia, University Hospitals Bristol NHS Foundation Trust; School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol.
Roles: Professor of neuroscience and anaesthesia
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Sabi Redwood
NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.
Roles: Senior research fellow in ethnography
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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.

  • chronic pain
  • health promotion
  • opioid-related disorders
  • pain
  • pain management
  • primary health care
  • Received April 18, 2019.
  • Revision requested May 1, 2019.
  • Accepted May 22, 2019.
  • ©The Authors

This article is Open Access: CC BY-NC 4.0 licence (http://creativecommons.org/licences/by-nc/4.0/).

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British Journal of General Practice: 70 (691)
British Journal of General Practice
Vol. 70, Issue 691
February 2020
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Acceptability of a primary care-based opioid and pain review service: a mixed-methods evaluation in England
Joanna M Kesten, Kyla Thomas, Lauren J Scott, Kevin Bache, Matthew Hickman, Rona Campbell, Anthony E Pickering, Sabi Redwood
British Journal of General Practice 2020; 70 (691): e120-e129. DOI: 10.3399/bjgp19X706097

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Acceptability of a primary care-based opioid and pain review service: a mixed-methods evaluation in England
Joanna M Kesten, Kyla Thomas, Lauren J Scott, Kevin Bache, Matthew Hickman, Rona Campbell, Anthony E Pickering, Sabi Redwood
British Journal of General Practice 2020; 70 (691): e120-e129. DOI: 10.3399/bjgp19X706097
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Keywords

  • chronic pain
  • health promotion
  • opioid-related disorders
  • pain
  • pain management
  • primary health care

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