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Experiences of people taking opioid medication for chronic non-malignant pain : a qualitative evidence synthesis using meta-ethnography
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Nichols, Vivien P., Toye, Francine, Eldabe, Sam, Sandhu, Harbinder, Underwood, Martin and Seers, Kate (2020) Experiences of people taking opioid medication for chronic non-malignant pain : a qualitative evidence synthesis using meta-ethnography. BMJ Open, 10 . e032988. doi:10.1136/bmjopen-2019-032988 ISSN 2044-6055.
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Official URL: http://dx.doi.org/10.1136/bmjopen-2019-032988
Abstract
Objective To review qualitative studies on the experience of taking opioid medication for chronic non-malignant pain (CNMP) or coming off them.
Design This is a qualitative evidence synthesis using a seven-step approach from the methods of meta-ethnography.
Data sources and eligibility criteria We searched selected databases—Medline, Embase, AMED, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science and Scopus (Science Citation Index and Social Science Citation Index)—for qualitative studies which provide patients’ views of taking opioid medication for CNMP or of coming off them (June 2017, updated September 2018).
Data extraction and synthesis Papers were quality appraised using the Critical Appraisal Skills Programme tool, and the GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation working group - Confidence in Evidence from Reviews of Qualitative research) guidelines were applied. We identified concepts and iteratively abstracted these concepts into a line of argument.
Results We screened 2994 unique citations and checked 153 full texts, and 31 met our review criteria. We identified five themes: (1) reluctant users with little choice; (2) understanding opioids: the good and the bad; (3) a therapeutic alliance: not always on the same page; (4) stigma: feeling scared and secretive but needing support; and (5) the challenge of tapering or withdrawal. A new overarching theme of ‘constantly balancing’ emerged from the data.
Conclusions People taking opioids were constantly balancing tensions, not always wanting to take opioids, and weighing the pros and cons of opioids but feeling they had no choice because of the pain. They frequently felt stigmatised, were not always ‘on the same page’ as their healthcare professional and felt changes in opioid use were often challenging.
Item Type: | Journal Article | ||||||||||||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing |
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Library of Congress Subject Headings (LCSH): | Opioids -- Prescribing, Chronic pain -- Treatment, Pain medicine, Pain -- Treatment | ||||||||||||||||||
Journal or Publication Title: | BMJ Open | ||||||||||||||||||
Publisher: | BMJ | ||||||||||||||||||
ISSN: | 2044-6055 | ||||||||||||||||||
Official Date: | 18 February 2020 | ||||||||||||||||||
Dates: |
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Volume: | 10 | ||||||||||||||||||
Article Number: | e032988 | ||||||||||||||||||
DOI: | 10.1136/bmjopen-2019-032988 | ||||||||||||||||||
Status: | Peer Reviewed | ||||||||||||||||||
Publication Status: | Published | ||||||||||||||||||
Reuse Statement (publisher, data, author rights): | “This is a pre- peer review version of (2020) A systematic review and qualitative evidence synthesis of the experiences of people taking opioid medication for chronic non-malignant pain : a meta-ethnography. BMJ Open . (In Press). The peer-reviewed Version of Record can be accessed online at [insert full DOI e.g. http://dx.doi.org/10.1136/xxxxx].” | ||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||||||||
Date of first compliant deposit: | 31 January 2020 | ||||||||||||||||||
Date of first compliant Open Access: | 31 January 2020 | ||||||||||||||||||
RIOXX Funder/Project Grant: |
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