General practitioners' and community pharmacists' beliefs and practices on opioids for non-malignant pain

IF 3.5 2区医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2024-06-24 DOI:10.1002/ejp.2304

E. A. W. Jansen-Groot Koerkamp, Y. M. Weesie, M. Heringa, K. Hek, J. W. Blom, M. E. Numans, L. van Dijk, M. L. Bouvy

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Abstract

Background

In Europe, opioid use has surged, largely due to prescriptions for chronic non-malignant pain (CNMP). General practitioners (GPs) and community pharmacists (CPs) play a major role in opioid prescribing for non-malignant pain. Exploring their personal beliefs and practices might reveal underlying mechanisms to identify measures that could halt the further escalation of opioid use.

Methods

Guided by the health belief model, a survey was designed and distributed nationwide to examine the practices and beliefs of GPs and CPs in the domains: threats, benefits, barriers and self-efficacy. The results of GPs and CPs were compared at the statement level using chi-square analysis.

Results

Of 214 GPs and 212 CPs who completed the survey, the majority agreed that too many opioids are used in the treatment of chronic non-malignant pain (66.8% GPs and 66.5% CPs). Furthermore, they were concerned about the addictive potential of opioids (83.1% GPs and 71.7% CPs). In general, both professions have concerns about opioid use. GPs report a slightly higher degree of self-efficacy and perceive fewer benefits from opioids in treating CNMP. GPs and CPs valued the recommended measures to reduce opioid prescribing, yet less than half actively implement these strategies in their clinics.

Conclusion

GPs and CPs believe that opioids are being used too frequently to treat CNMP. However, both professions lack the actions to improve opioid-related care. GPs and CPs require education, collaboration and tools to implement guidelines on non-malignant pain and opioids.

Significance

This study, guided by the health belief model, reveals that general practitioners and community pharmacists have serious concerns about opioid use in chronic non-malignant pain. Despite shared concerns, both professions differ in their beliefs about opioid benefits and perceived self-efficacy. Both professions have in common that they value recommended measures to reduce opioid prescribing. Also, they both struggle to implement strategies, emphasizing the urgent need for education, collaboration and tools to align practices with guidelines on non-malignant pain and opioids.

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全科医生和社区药剂师对阿片类药物治疗非恶性疼痛的看法和做法。

背景：在欧洲，阿片类药物的使用量激增，这主要是由于慢性非恶性疼痛（CNMP）的处方所致。全科医生（GP）和社区药剂师（CP）在非恶性疼痛的阿片类药物处方中发挥着重要作用。探索他们的个人信念和做法可能会揭示其潜在机制，从而确定可阻止阿片类药物使用进一步升级的措施：方法：在健康信念模型的指导下，设计并在全国范围内发放了一份调查问卷，从威胁、益处、障碍和自我效能等方面考察全科医生和社区医生的做法和信念。采用卡方分析法对全科医生和社区医生的调查结果进行了语句层面的比较：结果：在完成调查的 214 名全科医生和 212 名社区医生中，大多数人都认为在治疗慢性非恶性疼痛时使用了太多阿片类药物（全科医生占 66.8%，社区医生占 66.5%）。此外，他们还对阿片类药物的成瘾性表示担忧（全科医生占 83.1%，精神科医生占 71.7%）。总体而言，两个行业都对阿片类药物的使用表示担忧。全科医生的自我效能感略高，但认为阿片类药物在治疗 CNMP 方面的益处较少。全科医生和初级保健医生都重视减少阿片类药物处方的建议措施，但只有不到一半的人在其诊所中积极实施这些策略：全科医生和社区医生认为，阿片类药物在治疗 CNMP 方面的使用过于频繁。然而，这两个行业都缺乏改善阿片类药物相关护理的行动。全科医生和初级保健医生需要教育、合作和工具来实施非恶性疼痛和阿片类药物指南：本研究以健康信念模型为指导，揭示了全科医生和社区药剂师对阿片类药物在慢性非恶性疼痛中的使用的严重关切。尽管有共同的担忧，但这两个行业对阿片类药物的益处和自我效能感的信念却不尽相同。两个行业的共同点是，他们都重视减少阿片类药物处方的建议措施。此外，他们都在努力实施相关策略，强调迫切需要教育、合作和工具，使实践与非恶性疼痛和阿片类药物指南保持一致。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.