Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility Study
Unni Halvorsen,1 Ann Kristin Bjørnnes,2 Tone Marte Ljosaa1 1Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway; 2Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, NorwayCorrespondence: Unni Halvorsen, Department of Pain Management and Rese...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-04-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/nurse-led-telephone-follow-up-intervention-for-titrating-and-tapering--peer-reviewed-fulltext-article-JPR |
| _version_ | 1797844479976144896 |
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| author | Halvorsen U Bjørnnes AK Ljosaa TM |
| author_facet | Halvorsen U Bjørnnes AK Ljosaa TM |
| author_sort | Halvorsen U |
| collection | DOAJ |
| description | Unni Halvorsen,1 Ann Kristin Bjørnnes,2 Tone Marte Ljosaa1 1Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway; 2Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, NorwayCorrespondence: Unni Halvorsen, Department of Pain Management and Research, Oslo University Hospital, Pb 4950 Nydalen, Oslo, 0424, Norway, Tel + 47 23 02 61 61, Fax + 47 23 02 74 02, Email unhalv@ous-hf.noBackground and Purpose: Opioids in chronic non-cancer pain are debated, but remain a part of the pain treatment for selected patients. Research is scarce on the relieving and adverse effects of opioids, and how to deliver opioid treatment in this patient group. This study’s purpose was to assess the feasibility of a nurse-led telephone follow-up intervention for titrating or tapering opioids, including a pilot study of the intervention outcomes.Patients and Methods: The feasibility assessment and process evaluation were performed according to the UK Medical Research Council (MRC) framework for evaluating complex interventions. A pilot study of the intervention outcomes was also performed. With a retrospective, descriptive, and longitudinal approach, we analyzed reports from 32 patients who titrated or tapered opioids. Information on demography, sleep satisfaction, health status, pain intensity/bothersomeness, opioid doses, and side effects was derived from the Oslo Pain Registry. Descriptive statistics, t-tests, and chi-square tests were used to analyze registry data.Results: The study findings indicate that the intervention is feasible. Areas of impact were lack of a sound theory basis, unclear allocation criteria, and inconsistent and non-validated measurement tools. Mechanisms of change were interprofessional collaboration, nurses’ knowledge and competencies, predictability, and availability. Statistical analyses showed no between-groups differences in demographical-, clinical-, and pain characteristics, except those who titrated opioids were significantly older than patients tapering opioids (P=0.010). All patients reported poor health and side effects at baseline. Those who tapered opioids had a significant reduction in opioid use (P=0.004). Titrating opioids was associated with a significant increase in side effects (P=0.038).Conclusion: Considering the limitations and the strengths of the intervention, the present study indicates that the nurse-led telephone follow-up program is a feasible intervention. With the right adjustments and improvements, the intervention is eligible for a larger efficacy study.Keywords: opioids, feasibility study, register study, pilot study, process evaluation, health care personnel, chronic pain, nurse intervention |
| first_indexed | 2024-04-09T17:22:58Z |
| format | Article |
| id | doaj.art-a05dd2b8af684068ac217a3cd7bb1fa0 |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-04-09T17:22:58Z |
| publishDate | 2023-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-a05dd2b8af684068ac217a3cd7bb1fa02023-04-18T19:32:09ZengDove Medical PressJournal of Pain Research1178-70902023-04-01Volume 161285130083086Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility StudyHalvorsen UBjørnnes AKLjosaa TMUnni Halvorsen,1 Ann Kristin Bjørnnes,2 Tone Marte Ljosaa1 1Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway; 2Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, NorwayCorrespondence: Unni Halvorsen, Department of Pain Management and Research, Oslo University Hospital, Pb 4950 Nydalen, Oslo, 0424, Norway, Tel + 47 23 02 61 61, Fax + 47 23 02 74 02, Email unhalv@ous-hf.noBackground and Purpose: Opioids in chronic non-cancer pain are debated, but remain a part of the pain treatment for selected patients. Research is scarce on the relieving and adverse effects of opioids, and how to deliver opioid treatment in this patient group. This study’s purpose was to assess the feasibility of a nurse-led telephone follow-up intervention for titrating or tapering opioids, including a pilot study of the intervention outcomes.Patients and Methods: The feasibility assessment and process evaluation were performed according to the UK Medical Research Council (MRC) framework for evaluating complex interventions. A pilot study of the intervention outcomes was also performed. With a retrospective, descriptive, and longitudinal approach, we analyzed reports from 32 patients who titrated or tapered opioids. Information on demography, sleep satisfaction, health status, pain intensity/bothersomeness, opioid doses, and side effects was derived from the Oslo Pain Registry. Descriptive statistics, t-tests, and chi-square tests were used to analyze registry data.Results: The study findings indicate that the intervention is feasible. Areas of impact were lack of a sound theory basis, unclear allocation criteria, and inconsistent and non-validated measurement tools. Mechanisms of change were interprofessional collaboration, nurses’ knowledge and competencies, predictability, and availability. Statistical analyses showed no between-groups differences in demographical-, clinical-, and pain characteristics, except those who titrated opioids were significantly older than patients tapering opioids (P=0.010). All patients reported poor health and side effects at baseline. Those who tapered opioids had a significant reduction in opioid use (P=0.004). Titrating opioids was associated with a significant increase in side effects (P=0.038).Conclusion: Considering the limitations and the strengths of the intervention, the present study indicates that the nurse-led telephone follow-up program is a feasible intervention. With the right adjustments and improvements, the intervention is eligible for a larger efficacy study.Keywords: opioids, feasibility study, register study, pilot study, process evaluation, health care personnel, chronic pain, nurse interventionhttps://www.dovepress.com/nurse-led-telephone-follow-up-intervention-for-titrating-and-tapering--peer-reviewed-fulltext-article-JPRopioidsfeasibility studyregister studypilot studyprocess evaluationhealth care personnelchronic painnurse intervention |
| spellingShingle | Halvorsen U Bjørnnes AK Ljosaa TM Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility Study Journal of Pain Research opioids feasibility study register study pilot study process evaluation health care personnel chronic pain nurse intervention |
| title | Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility Study |
| title_full | Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility Study |
| title_fullStr | Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility Study |
| title_full_unstemmed | Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility Study |
| title_short | Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients – A Feasibility Study |
| title_sort | nurse led telephone follow up intervention for titrating and tapering opioids in chronic pain patients ndash a feasibility study |
| topic | opioids feasibility study register study pilot study process evaluation health care personnel chronic pain nurse intervention |
| url | https://www.dovepress.com/nurse-led-telephone-follow-up-intervention-for-titrating-and-tapering--peer-reviewed-fulltext-article-JPR |
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