SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands.
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Eur J Pain. 2024 Nov;28(10):1719-1731. doi: 10.1002/ejp.2304. Epub 2024 Jun 24.
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.
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.
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.
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.
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.
在欧洲，阿片类药物的使用大幅增加，主要是由于治疗慢性非恶性疼痛（CNMP）的处方。全科医生（GP）和社区药剂师（CP）在治疗非恶性疼痛的阿片类药物处方方面发挥着重要作用。探讨他们的个人信念和实践可能揭示潜在的机制，以确定可以阻止阿片类药物使用进一步升级的措施。
本研究以健康信念模型为指导，设计了一项全国性调查，以检查全科医生和社区药剂师在以下领域的实践和信念：威胁、益处、障碍和自我效能。使用卡方分析比较全科医生和社区药剂师在陈述层面的结果。
在完成调查的 214 名全科医生和 212 名社区药剂师中，大多数人认为在治疗慢性非恶性疼痛时使用了太多的阿片类药物（66.8%的全科医生和 66.5%的社区药剂师）。此外，他们对阿片类药物的成瘾潜力表示担忧（83.1%的全科医生和 71.7%的社区药剂师）。总的来说，这两个专业都对阿片类药物的使用表示关注。全科医生报告自我效能感略高，并认为阿片类药物在治疗 CNMP 方面益处较少。全科医生和社区药剂师重视减少阿片类药物处方的推荐措施，但不到一半的人在诊所积极实施这些策略。
全科医生和社区药剂师认为阿片类药物在治疗 CNMP 时使用过于频繁。然而，这两个专业都缺乏改善阿片类药物相关护理的行动。全科医生和社区药剂师需要接受教育、合作和工具，以实施非恶性疼痛和阿片类药物相关指南。
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慢性非恶性疼痛中阿片类药物使用的严重关注。尽管存在共同的担忧，但这两个专业在阿片类药物益处和感知自我效能方面的信念存在差异。这两个专业的共同点是他们重视减少阿片类药物处方的推荐措施。此外，他们都在努力实施策略，这强调了迫切需要教育、合作和工具，以使实践与非恶性疼痛和阿片类药物相关指南保持一致。
