Elphinston Rachel A, Pager Sue, Brown Kelly, Sterling Michele, Fatehi Farhad, Gray Paul, Hipper Linda, Cahill Lauren, Connor Jason P
RECOVER Injury Research Centre, The University of Queensland, Herston, Australia.
National Health and Medical Research Council Centre for Research Excellence - Better Health Outcomes for Compensable Injury, The University of Queensland, Brisbane, Australia.
JMIR Form Res. 2025 Jan 30;9:e57208. doi: 10.2196/57208.
Opioid medications are important for pain management, but many patients progress to unsafe medication use. With few personalized and accessible behavioral treatment options to reduce potential opioid-related harm, new and innovative patient-centered approaches are urgently needed to fill this gap.
This study involved the first phase of co-designing a digital brief intervention to reduce the risk of opioid-related harm by investigating the lived experience of chronic noncancer pain (CNCP) in treatment-seeking patients, with a particular focus on opioid therapy experiences.
Eligible patients were those aged between 18 and 70 years with CNCP at a clinically significant level of intensity (a score of ≥4 of 10). Purposive sampling was used to engage patients on public hospital waitlists via mail or through the treating medical specialist. Participants (N=18; n=10 women; mean age 49.5 years, SD 11.50) completed semistructured telephone interviews. Interviews were transcribed verbatim, thematically analyzed using grounded theory, and member checked by patients.
Eight overarching themes were found, listed in the order of their prominence from most to least prominent: limited treatment collaboration and partnership; limited biopsychosocial understanding of pain; continued opioid use when benefits do not outweigh harms; a trial-and-error approach to opioid use; cycles of hopefulness and hopelessness; diagnostic uncertainty; significant negative impacts tied to loss; and complexity of pain and opioid use journeys.
The findings of this study advance progress in co-designing digital brief interventions by actively engaging patient partners in their lived experiences of chronic pain and use of prescription opioid medications. The key recommendations proposed should guide the development of personalized solutions to address the complex care needs of patients with CNCP.
阿片类药物对疼痛管理很重要，但许多患者会发展为不安全用药。由于几乎没有个性化且易于获得的行为治疗方案来减少潜在的阿片类药物相关危害，因此迫切需要新的、以患者为中心的创新方法来填补这一空白。
本研究涉及共同设计一种数字简短干预措施的第一阶段，通过调查寻求治疗的慢性非癌性疼痛（CNCP）患者的生活经历，特别是阿片类药物治疗经历，以降低阿片类药物相关危害的风险。
符合条件的患者为年龄在18至70岁之间、患有临床显著强度（10分制中≥4分）的CNCP患者。采用目的抽样法，通过邮件或经主治医学专家联系公立医院候诊名单上的患者。参与者（N = 18；n = 10名女性；平均年龄49.5岁，标准差11.50）完成了半结构化电话访谈。访谈逐字记录，采用扎根理论进行主题分析，并由患者进行成员核对。
发现了八个总体主题，按突出程度从高到低列出：治疗协作和伙伴关系有限；对疼痛的生物心理社会理解有限；当益处不大于危害时仍继续使用阿片类药物；阿片类药物使用的试错方法；希望与绝望的循环；诊断不确定性；与丧失相关的重大负面影响；以及疼痛和阿片类药物使用历程的复杂性。
本研究结果通过让患者伙伴积极参与其慢性疼痛和处方阿片类药物使用的生活经历，推动了数字简短干预措施共同设计方面的进展。提出的关键建议应指导开发个性化解决方案，以满足CNCP患者的复杂护理需求。
