"I Prefer to Stay Away": A Qualitative Study of Patients in an Opioid-Sparing Pain Management Protocol.


Journal

Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354

Informations de publication

Date de publication:
01 04 2023
Historique:
pubmed: 18 11 2021
medline: 14 3 2023
entrez: 17 11 2021
Statut: ppublish

Résumé

The aim of this study was to explore beliefs and behaviors of opioid pain medications among patients undergoing elective surgery. Opioid dependence after surgery is a major contributor to the ongoing opioid epidemic. Recent efforts by surgeons and health systems have sought to improve the education patients receive regarding safe opioid use after surgery; however, little is known about patients' pre-existing beliefs surrounding opioids. Semistructured interviews were conducted with patients who underwent 1 of 4 common elective surgical procedures at 1 institution. Patients were specifically asked about their knowledge and beliefs about opioids before surgery and their opinions of opioid-sparing recovery after surgery. Coding was conducted through iterative steps, beginning with an initial cycle of rapid analysis, followed by focused coding, and thematic analysis. Twenty-one patients were interviewed. Three major themes emerged regarding patient opinions about using opioids after surgery. First, there was widespread awareness among patients about opioid medications, and preoperatively, patients had specific intentions about using opioids, often informed by this awareness. Second, patients described a spectrum of opioid related behavior which both aligned and conflicted with preoperative intentions. Third, there was tension among patients about opioid-free postoperative recovery, with patients expressing support, opposition, and emphasis on tailoring recovery to patient needs. Patients undergoing common surgical procedures often arrive at their surgical encounter with strong, pre-formed opinions about opioids. Eliciting these preexisting opinions may help surgeons better counsel patients about safe opioid use after surgery.

Sections du résumé

OBJECTIVE
The aim of this study was to explore beliefs and behaviors of opioid pain medications among patients undergoing elective surgery.
BACKGROUND
Opioid dependence after surgery is a major contributor to the ongoing opioid epidemic. Recent efforts by surgeons and health systems have sought to improve the education patients receive regarding safe opioid use after surgery; however, little is known about patients' pre-existing beliefs surrounding opioids.
METHODS
Semistructured interviews were conducted with patients who underwent 1 of 4 common elective surgical procedures at 1 institution. Patients were specifically asked about their knowledge and beliefs about opioids before surgery and their opinions of opioid-sparing recovery after surgery. Coding was conducted through iterative steps, beginning with an initial cycle of rapid analysis, followed by focused coding, and thematic analysis.
RESULTS
Twenty-one patients were interviewed. Three major themes emerged regarding patient opinions about using opioids after surgery. First, there was widespread awareness among patients about opioid medications, and preoperatively, patients had specific intentions about using opioids, often informed by this awareness. Second, patients described a spectrum of opioid related behavior which both aligned and conflicted with preoperative intentions. Third, there was tension among patients about opioid-free postoperative recovery, with patients expressing support, opposition, and emphasis on tailoring recovery to patient needs.
CONCLUSIONS
Patients undergoing common surgical procedures often arrive at their surgical encounter with strong, pre-formed opinions about opioids. Eliciting these preexisting opinions may help surgeons better counsel patients about safe opioid use after surgery.

Identifiants

pubmed: 34787984
doi: 10.1097/SLA.0000000000005087
pii: 00000658-202304000-00010
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

596-602

Subventions

Organisme : NIDA NIH HHS
ID : R01 DA042859
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK108740
Pays : United States

Informations de copyright

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Références

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Auteurs

Emily Johnson (E)

University of Michigan Medical School, Ann Arbor, MI.

Maxwell Yoshida (M)

Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI.

Alexander Hallway (A)

Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI.

Mary Byrnes (M)

Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, MI.
Department of Surgery, Michigan Medicine, Ann Arbor, Mi.

Jennifer Waljee (J)

Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI.
Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, MI.
Section of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI.

Michael Englesbe (M)

Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI.
Section of Transplant Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI.

Ryan Howard (R)

Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, MI.
Department of Surgery, Michigan Medicine, Ann Arbor, Mi.

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