Swallowing the pill of adverse effects

A qualitative study of patients' and pharmacists' experiences and decision‐making regarding the adverse effects of chronic pain medications

Datos Bibliográficos

ID19508435
AutoresLise Dassieu (0000-0002-6311-3681, Research Center of the Centre hospitalier de l'Université de Montréal Montreal Quebec Canada, autor de correspondencia), Emilie Paul‐Savoie (Quebec Pain Research Network Sherbrooke Quebec Canada), Émilie Paul-Savoie (0000-0003-0147-6804, Université de Sherbrooke), Élise Develay (0009-0006-7265-0557, Research Center of the Centre hospitalier de l'Université de Montréal Montreal Quebec Canada), Ana Cecilia Villela Guilhon (0000-0002-1582-1069, Research Center of the Centre hospitalier de l'Université de Montréal Montreal Quebec Canada), Anaïs Lacasse (0000-0002-3992-5145, Quebec Pain Research Network Sherbrooke Quebec Canada), Line Guénette (0000-0001-9769-7550, Quebec Pain Research Network Sherbrooke Quebec Canada), Kadija Perreault (0000-0002-8608-9661, Quebec Pain Research Network Sherbrooke Quebec Canada), Hélène Beaudry (0000-0002-0869-3767, Quebec Pain Research Network Sherbrooke Quebec Canada), Laurent Dupuis (Quebec Pain Research Network Sherbrooke Quebec Canada)
Año2022
Volumen25
Número1
Páginas394-407
Fecha de publicación2022-02-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Expectations (JOURNAL)
Identificadores de la revistaISSN: 1369-6513 • E-ISSN: 1369-7625
EditorialWiley (PUBLISHER • GB)
DOI10.1111/hex.13399
PMID34935258
OpenAlexW4200477775
IdiomaEN
Citas recibidas4
Referencias citadas68

INTRODUCTION: Pharmacological treatments of chronic pain can lead to numerous and sometimes serious adverse effects. Drawing on a social science approach to chronic illness, this study aimed to understand the experiences of people living with chronic pain and community pharmacists regarding the definition, prevention and management of analgesic adverse effects. METHODS: This qualitative study proceeded through 12 online focus groups (FGs) with people living with chronic pain (n = 26) and community pharmacists (n = 19), conducted between July 2020 and February 2021 in the province of Quebec, Canada. The semistructured discussion guides covered participants' definitions of adverse effects and decision-making regarding their prevention and management. Discussions were audio-recorded, transcribed verbatim and analysed using grounded theory. RESULTS: Both people with chronic pain and pharmacists provided varying definitions of analgesic adverse effects depending on patients' social and clinical characteristics. Present quality of life and serious long-term risks related to treatment were described as key dimensions influencing adverse effect appraisal. Dilemmas and discrepancies occurred between patients and pharmacists when choosing to prioritize pain relief or adverse effect prevention. Some patients lacked information about their medications and wanted to be more involved in decisions, while many pharmacists were concerned by patients' self-management of adverse effects. Preventing opioid-related overdoses often led pharmacists to policing practices. Despite most pharmacists wishing they could have a key role in the management of pain and adverse effects face organizational and financial barriers. CONCLUSION: Defining, preventing and managing adverse effects in the treatment of chronic pain requires a person-centred approach and shared decision-making. Clinical training improvements and healthcare organization changes are needed to support pharmacists in providing patients with community-based follow-up and reliable information about the adverse effects of chronic pain treatments. PATIENT OR PUBLIC CONTRIBUTION: A person with lived experience of chronic pain was involved as a coinvestigator in the study. He contributed to shaping the study design and objectives, including major methodological decisions such as the choice of pharmacists as the most appropriate professionals to investigate. In addition, 26 individuals with chronic pain shared their experiences extensively during the FGs

Adverse effect · Analgesic · Chronic pain · Family medicine · Focus group · Grounded theory · Intensive care medicine · Medical prescription · Pill · Psychiatry · Qualitative research · Medicine · Musculoskeletal pain and rehabilitation · Nursing · Opioid Use Disorder Treatment · Pain Management and Opioid Use · Pharmacology