Clinicians’ perspective of the opioid analgesic stewardship in acute pain clinical care standard

Objectives

Opioid analgesics are high-risk medicines, widely used in hospitals to manage pain. To improve the use of opioids in Australia, The Australian Commission on Safety and Quality in Health Care released the first national Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard (Opioid Stewardship Standard). The objective of this study was to explore clinicians’ perspectives of the implementation of the Opioid Stewardship Standard to understand factors that may impact this process.

Methods

Qualitative one-on-one interviews were conducted with clinicians, including doctors, pharmacists, nurses, and patient safety officers. The interview guide was developed based on the Consolidated Framework of Implementation Research. Interview transcriptions were thematically analyzed using an inductive approach to identify common themes.

Results

In total, 32 clinicians were interviewed, including 10 doctors, 10 pharmacists, and 12 nurses from 26 sites across Australia. Themes identified included: (i) Organizational priorities, (ii) organizational capacity for implementation, (iii) changing prescribing practices, and (iv) the Opioid Stewardship Standard.

Conclusions

Clinicians’ perceptions were categorized into four themes regarding the implementation of the Opioid Stewardship Standard. Key findings from this study included the importance of local data to increase organizational prioritization, availability of resources and staffing to increase organizational capacity for implementation to implement the Opioid Stewardship Standard. Future studies should evaluate the impact of such strategies on implementation.

Lay summary

Health professionals need more support from the health system to deliver health care that aligns with policies such as the Opioid Stewardship Standard. Organisations within the health system should consider providing support such as staffing to meet these needs.