Sophie A Young, Chi Tran, Claire E Ashton-James, Asad E Patanwala, Jennifer Stevens, Justine M Naylor, Furkan Genel, Sam Adie, Bernadette Brady, Kate Luckie, Geraldine Hassett, Gilbert Whitton, Joseph Descallar, Frances Page, Mary Keehan, Cheng Fai Hui, Shaniya Ogul, Anders G Jansson, Amy Archer, Andrew Sefton, Mitchell Fung, Thomas Byrnes, Geoffrey Murphy, Erica Morgan, Emily Mayze, Clare Eastment, Shania Liu, Jonathan Penm
{"title":"A pharmacist-partnered opioid tapering service before total hip or knee arthroplasty: Qualitative analysis of patient counselling sessions.","authors":"Sophie A Young, Chi Tran, Claire E Ashton-James, Asad E Patanwala, Jennifer Stevens, Justine M Naylor, Furkan Genel, Sam Adie, Bernadette Brady, Kate Luckie, Geraldine Hassett, Gilbert Whitton, Joseph Descallar, Frances Page, Mary Keehan, Cheng Fai Hui, Shaniya Ogul, Anders G Jansson, Amy Archer, Andrew Sefton, Mitchell Fung, Thomas Byrnes, Geoffrey Murphy, Erica Morgan, Emily Mayze, Clare Eastment, Shania Liu, Jonathan Penm","doi":"10.1097/ALN.0000000000005594","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Currently, no literature on patients' experiences with opioid tapering before elective surgery has been published. Recent evidence indicates tapering opioids before total hip or knee arthroplasty improves post-surgical outcomes. This study qualitatively analyzed consultation sessions of patients receiving a pharmacist-partnered opioid tapering service before total hip or knee replacement surgery to understand their experiences and attitudes.</p><p><strong>Methods: </strong>A qualitative analysis of pharmacist counselling sessions within a randomised controlled trial (RCT) was conducted. Participants were those recruited from seven hospitals between December 2021 and September 2022 who were assigned to the pharmacist-partnered opioid tapering intervention arm of the RCT. Consultations of participants with the pharmacist were audio-recorded and transcribed verbatim. Consultation data underwent inductive thematic analysis.</p><p><strong>Results: </strong>Consultations were available for 20 participants, with a total of 48 audio-recorded consultations. Among these participants, four major themes including motivations to taper, knowledge and beliefs, psychosocial context, and attitudes towards tapering opioids were identified. Of the 20 participants, 70% tapered their opioids ≥50%, with awareness of the surgery date appearing to be a key external motivating factor to taper opioids, regardless of the dose of opioids. Another notable theme was the motivation to improve fitness for participation in social activities, allowing participants to interact more with their kids and grandkids. Additionally, participant's psychosocial context revealed that factors such as stress impacted their ability to taper. Pharmacists played a foundational role in shaping patients' attitudes and optimisation of pain management strategies. Attitudes were identified as 'optimistic', 'hesitant', and 'resistant', with patients displaying an optimistic attitude being more likely to taper.</p><p><strong>Conclusions: </strong>Exploring the experiences of patients with osteoarthritis in a pharmacist-led opioid tapering service before elective surgery revealed that external motivations, such as knowledge of a surgery date, play a crucial role in successful opioid tapering. Patients were more likely to taper if they knew their surgery date. Attitudes towards opioid tapering were identified as a modifiable factor. Tailoring tapering plans and patient education to individual patient contexts may enhance tapering outcomes.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1000,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ALN.0000000000005594","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Currently, no literature on patients' experiences with opioid tapering before elective surgery has been published. Recent evidence indicates tapering opioids before total hip or knee arthroplasty improves post-surgical outcomes. This study qualitatively analyzed consultation sessions of patients receiving a pharmacist-partnered opioid tapering service before total hip or knee replacement surgery to understand their experiences and attitudes.
Methods: A qualitative analysis of pharmacist counselling sessions within a randomised controlled trial (RCT) was conducted. Participants were those recruited from seven hospitals between December 2021 and September 2022 who were assigned to the pharmacist-partnered opioid tapering intervention arm of the RCT. Consultations of participants with the pharmacist were audio-recorded and transcribed verbatim. Consultation data underwent inductive thematic analysis.
Results: Consultations were available for 20 participants, with a total of 48 audio-recorded consultations. Among these participants, four major themes including motivations to taper, knowledge and beliefs, psychosocial context, and attitudes towards tapering opioids were identified. Of the 20 participants, 70% tapered their opioids ≥50%, with awareness of the surgery date appearing to be a key external motivating factor to taper opioids, regardless of the dose of opioids. Another notable theme was the motivation to improve fitness for participation in social activities, allowing participants to interact more with their kids and grandkids. Additionally, participant's psychosocial context revealed that factors such as stress impacted their ability to taper. Pharmacists played a foundational role in shaping patients' attitudes and optimisation of pain management strategies. Attitudes were identified as 'optimistic', 'hesitant', and 'resistant', with patients displaying an optimistic attitude being more likely to taper.
Conclusions: Exploring the experiences of patients with osteoarthritis in a pharmacist-led opioid tapering service before elective surgery revealed that external motivations, such as knowledge of a surgery date, play a crucial role in successful opioid tapering. Patients were more likely to taper if they knew their surgery date. Attitudes towards opioid tapering were identified as a modifiable factor. Tailoring tapering plans and patient education to individual patient contexts may enhance tapering outcomes.
期刊介绍：
With its establishment in 1940, Anesthesiology has emerged as a prominent leader in the field of anesthesiology, encompassing perioperative, critical care, and pain medicine. As the esteemed journal of the American Society of Anesthesiologists, Anesthesiology operates independently with full editorial freedom. Its distinguished Editorial Board, comprising renowned professionals from across the globe, drives the advancement of the specialty by presenting innovative research through immediate open access to select articles and granting free access to all published articles after a six-month period. Furthermore, Anesthesiology actively promotes groundbreaking studies through an influential press release program. The journal's unwavering commitment lies in the dissemination of exemplary work that enhances clinical practice and revolutionizes the practice of medicine within our discipline.
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