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Development and testing of an opioid tapering self-management intervention for chronic pain : I-WOTCH

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Sandhu, Harbinder, Shaw, Jane, Carnes, Dawn, Furlan, Andrea D., Tysall, Colin, Adjei, Henry, Muthiah, Chockalingam, Noyes, Jennifer, Tang, Nicole K. Y., Taylor, Stephanie J. C., Underwood, Martin, Willis, Adrian and Eldabe, Sam (2022) Development and testing of an opioid tapering self-management intervention for chronic pain : I-WOTCH. BMJ Open, 12 (3). e053725. doi:10.1136/bmjopen-2021-053725

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Official URL: https://doi.org/10.1136/bmjopen-2021-053725

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Abstract

Objectives: To describe the design, development and pilot of a multicomponent intervention aimed at supporting withdrawal of opioids for people with chronic non-malignant pain for future evaluation in the Improving the Wellbeing of people with Opioid Treated CHronic pain (I-WOTCH) randomised controlled trial. Design: The I-WOTCH intervention draws on previous literature and collaboration with stakeholders (patient and public involvement). Intervention mapping and development activities of Behaviour Change Taxonomy are described. Setting: The intervention development was conducted by a multidisciplinary team with clinical, academic and service user perspectives. The team had expertise in the development and testing of complex health behaviour interventions, opioid tapering and pain management in primary and secondary care, I.T programming, and software development—to develop an opioid tapering App. Participants: The I-WOTCH trial participants are adults (18 years and over) with chronic non-malignant pain using strong opioids for at least 3 months and on most days in the preceding month. Outcomes: A multicomponent self-management support package to help people using opioids for chronic non-malignant pain reduce opioid use. Interventions and results: Receiving information on the impact of long-term opioid use, and potential adverse effects were highlighted as important facilitators in making the decision to reduce opioids. Case studies of those who have successfully stopped taking opioids were also favoured as a facilitator to reduce opioid use. Barriers included the need for a ‘trade-off to fill the deficit of the effect of the drug’. The final I-WOTCH intervention consists of an 8–10 week programme incorporating: education; problem-solving; motivation; group and one to one tailored planning; reflection and monitoring. A detailed facilitator manual was developed to promote consistent delivery of the intervention across the UK. Conclusions: We describe the development of an opioid reduction intervention package suitable for testing in the I-WOTCH randomised controlled trial. Trial registration number: ISRCTN49470934.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Science > Psychology
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Chronic pain -- Treatment, Pain -- Treatment, Opioids, Well-being, Self-management (Psychology)
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 15 March 2022
Dates:
DateEvent
15 March 2022Published
31 January 2022Accepted
Volume: 12
Number: 3
Article Number: e053725
DOI: 10.1136/bmjopen-2021-053725
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
14/224/04Health Technology Assessment programmehttp://dx.doi.org/10.13039/501100000664
ARC North Thames[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Contributors:
ContributionNameContributor ID
Research GroupThe I-WOTCH Team, UNSPECIFIED

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