Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations]
Background Opioids are frequently prescribed for short-term acute pain following surgery. Used appropriately, opioids deliver extremely favourable pain relief. Used longer than 90-days, however, can result in health complications, including unintentional overdose and addiction. Globally, >40 mill...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
F1000 Research Ltd
2025-01-01
|
| Series: | NIHR Open Research |
| Subjects: | |
| Online Access: | https://openresearch.nihr.ac.uk/articles/4-48/v2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832590333810049024 |
|---|---|
| author | Ellie Santer Julie H Hedayioglu Vanessa J Short Sabina Hulbert Emma L Veale Melanie Rees-Roberts Johanna Theron |
| author_facet | Ellie Santer Julie H Hedayioglu Vanessa J Short Sabina Hulbert Emma L Veale Melanie Rees-Roberts Johanna Theron |
| author_sort | Ellie Santer |
| collection | DOAJ |
| description | Background Opioids are frequently prescribed for short-term acute pain following surgery. Used appropriately, opioids deliver extremely favourable pain relief. Used longer than 90-days, however, can result in health complications, including unintentional overdose and addiction. Globally, >40 million people are dependent on opioids and annually >100,000 die from opioid misuse. With >4.7 million surgical procedures occurring annually in the United Kingdom it is imperative that opioid-use is managed upon discharge. A declining General Practitioner (GP) workforce and increased patient numbers, however, means gaps in healthcare during transfer of care. Here we report a mixed-methods protocol to understand the feasibility, and acceptability of a clinical pharmacist (CP)-led early opioid deprescribing intervention for discharged surgical patients. Methods DESCALE is a multicentre, non-randomised, pragmatic feasibility study. Participants aged ≥18 years who have undergone a surgical procedure at a single NHS trust in Southeast England and discharged with opioids and without a history of long-term opioid use, cancer diagnosis or study contraindications will be offered a Medicines Use Review (MUR) within 7-10 days of discharge. The MUR will be delivered by CPs at participating GP practices. Feasibility outcomes will focus on recruitment, fidelity of CPs to deliver the MUR, and barriers within primary care that affect delivery of the intervention, with a maximum sample size of 100. Clinical outcomes will focus on the number of participants that reduce or stop opioid use within 91 days. Prescribing, medical, surgical, and demographic data for individual participants will be collected and analysed to inform future trial design. Qualitative interviews with participants and associated healthcare professionals will explore acceptability and implementation of the intervention. Conclusion Data collected with respect to opioid use post-surgery, feasibility and acceptability of the intervention, patient experience and outcome data will inform the design of future research and larger clinical trials. |
| format | Article |
| id | doaj-art-6f75a9f6e22b402facec0046ef9af42b |
| institution | Kabale University |
| issn | 2633-4402 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | NIHR Open Research |
| spelling | doaj-art-6f75a9f6e22b402facec0046ef9af42b2025-01-24T01:00:00ZengF1000 Research LtdNIHR Open Research2633-44022025-01-01415070Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations]Ellie Santer0Julie H Hedayioglu1https://orcid.org/0000-0002-9805-7421Vanessa J Short2https://orcid.org/0000-0001-6231-0707Sabina Hulbert3Emma L Veale4https://orcid.org/0000-0002-6778-9929Melanie Rees-Roberts5Johanna Theron6https://orcid.org/0009-0005-5417-545XCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NF, UKResearch & Development, Kent Community Health NHS Foundation Trust, Ashford, England, TN25 4AZ, UKCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NF, UKCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NF, UKMedway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, ME4 4TB, UKCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NF, UKCommunity Chronic Pain Team, Kent Community Health NHS Foundation Trust, Margate, CT9 1LB, UKBackground Opioids are frequently prescribed for short-term acute pain following surgery. Used appropriately, opioids deliver extremely favourable pain relief. Used longer than 90-days, however, can result in health complications, including unintentional overdose and addiction. Globally, >40 million people are dependent on opioids and annually >100,000 die from opioid misuse. With >4.7 million surgical procedures occurring annually in the United Kingdom it is imperative that opioid-use is managed upon discharge. A declining General Practitioner (GP) workforce and increased patient numbers, however, means gaps in healthcare during transfer of care. Here we report a mixed-methods protocol to understand the feasibility, and acceptability of a clinical pharmacist (CP)-led early opioid deprescribing intervention for discharged surgical patients. Methods DESCALE is a multicentre, non-randomised, pragmatic feasibility study. Participants aged ≥18 years who have undergone a surgical procedure at a single NHS trust in Southeast England and discharged with opioids and without a history of long-term opioid use, cancer diagnosis or study contraindications will be offered a Medicines Use Review (MUR) within 7-10 days of discharge. The MUR will be delivered by CPs at participating GP practices. Feasibility outcomes will focus on recruitment, fidelity of CPs to deliver the MUR, and barriers within primary care that affect delivery of the intervention, with a maximum sample size of 100. Clinical outcomes will focus on the number of participants that reduce or stop opioid use within 91 days. Prescribing, medical, surgical, and demographic data for individual participants will be collected and analysed to inform future trial design. Qualitative interviews with participants and associated healthcare professionals will explore acceptability and implementation of the intervention. Conclusion Data collected with respect to opioid use post-surgery, feasibility and acceptability of the intervention, patient experience and outcome data will inform the design of future research and larger clinical trials.https://openresearch.nihr.ac.uk/articles/4-48/v2Opioids deprescribing surgery dependence clinical pharmacists Medicines Use Revieweng |
| spellingShingle | Ellie Santer Julie H Hedayioglu Vanessa J Short Sabina Hulbert Emma L Veale Melanie Rees-Roberts Johanna Theron Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations] NIHR Open Research Opioids deprescribing surgery dependence clinical pharmacists Medicines Use Review eng |
| title | Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full | Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_fullStr | Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full_unstemmed | Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_short | Pharmacist-led DE-eSCALation of opioids post-surgical dischargE (DESCALE) – A multi-centre, non-randomised, feasibility study protocol [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_sort | pharmacist led de escalation of opioids post surgical discharge descale a multi centre non randomised feasibility study protocol version 2 peer review 1 approved 2 approved with reservations |
| topic | Opioids deprescribing surgery dependence clinical pharmacists Medicines Use Review eng |
| url | https://openresearch.nihr.ac.uk/articles/4-48/v2 |
| work_keys_str_mv | AT elliesanter pharmacistleddeescalationofopioidspostsurgicaldischargedescaleamulticentrenonrandomisedfeasibilitystudyprotocolversion2peerreview1approved2approvedwithreservations AT juliehhedayioglu pharmacistleddeescalationofopioidspostsurgicaldischargedescaleamulticentrenonrandomisedfeasibilitystudyprotocolversion2peerreview1approved2approvedwithreservations AT vanessajshort pharmacistleddeescalationofopioidspostsurgicaldischargedescaleamulticentrenonrandomisedfeasibilitystudyprotocolversion2peerreview1approved2approvedwithreservations AT sabinahulbert pharmacistleddeescalationofopioidspostsurgicaldischargedescaleamulticentrenonrandomisedfeasibilitystudyprotocolversion2peerreview1approved2approvedwithreservations AT emmalveale pharmacistleddeescalationofopioidspostsurgicaldischargedescaleamulticentrenonrandomisedfeasibilitystudyprotocolversion2peerreview1approved2approvedwithreservations AT melaniereesroberts pharmacistleddeescalationofopioidspostsurgicaldischargedescaleamulticentrenonrandomisedfeasibilitystudyprotocolversion2peerreview1approved2approvedwithreservations AT johannatheron pharmacistleddeescalationofopioidspostsurgicaldischargedescaleamulticentrenonrandomisedfeasibilitystudyprotocolversion2peerreview1approved2approvedwithreservations |