Pragmatic Delphi study aimed at determining practical components for a tool designed to assist Dutch primary care-givers in opioid deprescribing for non-cancer pain
Family Practice, vol. 40, pp. 827–843
Abstract
BACKGROUND: Over the past decades, opioid prescriptions have increased in the Netherlands. The Dutch general practitioners' guideline on pain was recently updated and now aims to reduce opioid prescriptions and high-risk opioid use for non-cancer pain. The guideline, however, lacks practical measures for implementation. OBJECTIVE: This study aims to determine practical components for a tool that should assist Dutch primary care prescribers and implements the recently updated guideline to reduce opioid prescriptions and high-risk use. METHODS: A modified Delphi approach was used. The practical components for the tool were identified based on systematic reviews, qualitative studies, and Dutch primary care guidelines. Suggested components were divided into Part A, containing components designed to reduce opioid initiation and stimulate short-term use, and Part B, containing components designed to reduce opioid use among patients on long-term opioid treatment. During three rounds, a multidisciplinary panel of 21 experts assessed the content, usability, and feasibility of these components by adding, deleting, and adapting components until consensus was reached on the outlines of an opioid reduction tool. RESULTS: The resulting Part A consisted of six components, namely education, opioid decision tree, risk assessment, agreements on dosage and duration of use, guidance and follow-up, and interdisciplinary collaboration. The resulting Part B consisted of five components, namely education, patient identification, risk assessment, motivation, and tapering. CONCLUSIONS: In this pragmatic Delphi study, components for an opioid reduction tool for Dutch primary care-givers are identified. These components need further development, and the final tool should be tested in an implementation study.
Authors 10
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Utrecht University · SIR Institute for Pharmacy Practice and Policy
Affiliation as printed
Division of Pharmaco-epidemiology and Clinical Pharmacology, Utrecht University , Utrecht , The Netherlands
SIR Institute for Pharmacy Practice and Policy , Leiden , The Netherlands
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Loes de Kleijn corresponding
Erasmus MC · Erasmus University Rotterdam
Affiliation as printed
Department of General Practice, Erasmus University Medical Center , Rotterdam , The Netherlands
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Affiliation as printed
Division of Pharmaco-epidemiology and Clinical Pharmacology, Utrecht University , Utrecht , The Netherlands
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Erasmus MC · Erasmus University Rotterdam
Affiliation as printed
Department of General Practice, Erasmus University Medical Center , Rotterdam , The Netherlands
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SIR Institute for Pharmacy Practice and Policy
Affiliation as printed
SIR Institute for Pharmacy Practice and Policy , Leiden , The Netherlands
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Erasmus MC · Erasmus University Rotterdam
Affiliation as printed
Department of General Practice, Erasmus University Medical Center , Rotterdam , The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department Public Health and Primary Care, Leiden University Medical Center , Leiden , The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department Public Health and Primary Care, Leiden University Medical Center , Leiden , The Netherlands
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University of Southern Denmark · Erasmus MC · Erasmus University Rotterdam
Affiliation as printed
Department of General Practice, Erasmus University Medical Center , Rotterdam , The Netherlands
Research Unit of General Practice, Department of Public Health and the Center for Muscle and Joint Health, University of Southern Denmark , Odense , Denmark
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Affiliation as printed
Division of Pharmaco-epidemiology and Clinical Pharmacology, Utrecht University , Utrecht , The Netherlands
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