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

• Published in: Health policy and technology 2024-11, Vol.13 (5), p.100936, Article 100936
• Main Authors: Dutkiewicz, Chelsea, Liu, Shania, Patanwala, Asad, McLachlan, Andrew J, Stevens, Jennifer, Khor, Kok Eng, Bugeja, Bernadette, Begley, David, Fong, Ian, Jauregui, Katelyn, Penm, Jonathan
• Format: Article
• Language: English
• Subjects: Acute pain; Clinical care standard; Clinicians; Implementation science; Opioid stewardship; Qualitative research
• ISSN: 2211-8837
• DOI: 10.1016/j.hlpt.2024.100936

·Australian Opioid Stewardship Standards were released in 2022 to describe appropriate healthcare practices and quality indicator metrics for acute pain management.·Clinicians require additional organizational support in terms of staffing and resources to feel confident in their ability to implement the Opioid Stewardship Standard.·Organizations may increase implementation of opioid clinical care standards through the creation of a governance structure, consisting of a multidisciplinary team and an opioid stewardship pharmacist role. 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. 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. 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. 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. 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.