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Innovative study to improve care for people using opioids for long-term pain


A new NIHR-funded study is set to help improve care for people using opioids for long-term pain, by testing a way to train pharmacists to support these patients.

The PROMPPT trial (Proactive clinical Review of patients taking Opioid Medicines long-term for persistent Pain led by clinical Pharmacists in primary care Teams) is funded by NIHR’s Programme Grants for Applied Research scheme and led by researchers at Keele University.

The five-year study will focus on patients using opioid drugs, a group that includes codeine and morphine. Although opioids can be very effective for short-term pain, for many people they are not helpful in the long-term - with a recent Public Health England report finding that more patients are becoming dependent on the drugs.

The new study will be seeking views from patients, pharmacists and GPs to help design a new way for clinical pharmacists to work with teams in GP surgeries to review patients who are taking opioids long term. This new approach could involve pharmacists helping patients to stop or reduce their use of opioids if appropriate, and supporting them in coping with long-term pain.

One issue is that people do not realise that their pain medicines are opioids or know about the risks associated with long-term use.

The research team has set up an online discussion forum for patients called the Q-PROMPPT blog, so that participants can take part via the internet, as and when they want to.

Dr Julie Ashworth, Senior Lecturer in Pain Medicine at Keele’s School for Primary, Community and Social Care, co-leads the PROMPPT programme and said: “By really understanding the views of people with experience of long-term pain and using opioid painkillers through the online blog, we can develop a clinical pharmacist review that is relevant, useful and appealing to the people who will use it. Too often, people with long-term pain struggle to find the help they need and this study is a great opportunity for their voice to be heard.”

Health Secretary Matt Hancock said: “We are in the grip of an over-medication crisis and it is vital that we help people find alternatives to addictive opioids to manage their pain. This government-funded study will help pharmacists and health professionals better support their patients and help move them onto more effective treatments.

“We have seen in the United States the devastation that is caused by opioid addiction – we cannot and will not allow that to happen in this country and I urge anyone eligible to participate in this vital research.”

Louise Trewern has lived with pain for most of her adult life. She said: “I used opioids for over 12 years. At first, they helped me to cope better and to carry on looking after my children and running my home.”

But the benefits Louise experienced were not long-lasting. She said: “Even on the opioids my pain would get worse and my dose was increased. That worked for a while, until it didn’t, and then my dose would be increased again.

“At the same time, my skin condition became worse, a cold would put me in bed for a week and I put on weight. I nodded off in the day, even in the middle of a video-call with my grandson but I couldn’t sleep at night.

“Taking part in this research is an amazing opportunity for me and others like myself who live with pain to improve the care that we receive.”

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