Patient perspectives on buprenorphine/naloxone for chronic noncancer pain: A qualitative interview study.

Abstract

Background: Buprenorphine/naloxone (Suboxone) is an emerging option for chronic noncancer pain (CNCP), but evidence on transitioning patients from full opioid agonists remains limited. At the University of Saskatchewan Chronic Pain Clinic (UCPC) in Saskatchewan, Canada, pharmacists support these transitions within a unique interdisciplinary model.

Aim: The aim of this study was to explore patient perspectives on transitioning to and using buprenorphine/naloxone for CNCP.

Methods: This qualitative study involved one-on-one semistructured interviews with current and former UCPC patients who had transitioned to buprenorphine/naloxone for CNCP. Participants were invited by email to complete semistructured interviews via Zoom or telephone with a trained facilitator. The interview guide was informed by a literature review and pretested. Recorded interviews were transcribed using an artificial intelligence-supported platform, reviewed for accuracy, and analyzed in NVivo 14 using thematic analysis.

Results: Seven participants (five females, two males; average age 57 years) were interviewed. Most had used opioids long term for pain prior to transition. Experiences varied: some transitioned easily, whereas others required more time or experienced discomfort. Buprenorphine/naloxone tablet size and taste were the most common negative experiences. Side effects were mild (e.g. drowsiness, constipation). Some expressed concern about long-term use and desired clearer communication during transitions. Although buprenorphine/naloxone was not uniformly experienced as effective for pain relief, most would recommend buprenorphine/naloxone to others.

Conclusion: Patient experiences at UCPC suggest that though buprenorphine/naloxone is not a universal solution for CNCP, it may be an effective option for carefully selected individuals. Side effects were tolerable, and most would recommend the treatment. Improved communication during transitions may enhance patient experiences.