Abstract
Study objective: When risks and side effects of pain medication use outweigh its benefits, pain medication tapering (PMT) should be considered. PMT gained prominence in the treatment plan for patients with chronic pain (CP) and consist of heterogeneous components. This study aims to clarify the concept of PMT by conceptualizing essential components for use in CP patients.
Design: Concept analysis based on the eight-step method of Walker and Avant.
Data sources: A comprehensive literature search up to July 2023 was performed in six databases: MEDLINE (via PubMed), Web of Science, Embase, Scopus, PsychINFO and the Cochrane database.
Patients: CP patients on long-term pain medication therapy to whom PMT is beneficial.
Interventions: Attributes, illustrative cases, antecedents, consequences and empirical referents were developed. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for transparency and reproducibility of the search, and to increase readability and clarity.
Main results: Out of 4,162 articles, 110 articles were included. Six attributes were identified: medication use and decrease, support, patient preparation/education, personalization, controlling and monitoring throughout and following tapering, and alternative treatments for pain relief. Three cases were developed, illustrating PMT programs containing all, some or none of the attributes. Antecedents such as suitability for tapering, convinced patient, experienced multidisciplinary team and well-established patient-physician relationship were identified, and consequences were described according to the International Classification of Functioning, Disability and Health, with results predominantly found in the body functions and structures category.
Conclusion: Conceptualization of PMT for patients with CNCP creates a common ground for improving current knowledge about PMT programs and can serve as a starting point for development of future research into PMT interventions.
Design: Concept analysis based on the eight-step method of Walker and Avant.
Data sources: A comprehensive literature search up to July 2023 was performed in six databases: MEDLINE (via PubMed), Web of Science, Embase, Scopus, PsychINFO and the Cochrane database.
Patients: CP patients on long-term pain medication therapy to whom PMT is beneficial.
Interventions: Attributes, illustrative cases, antecedents, consequences and empirical referents were developed. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for transparency and reproducibility of the search, and to increase readability and clarity.
Main results: Out of 4,162 articles, 110 articles were included. Six attributes were identified: medication use and decrease, support, patient preparation/education, personalization, controlling and monitoring throughout and following tapering, and alternative treatments for pain relief. Three cases were developed, illustrating PMT programs containing all, some or none of the attributes. Antecedents such as suitability for tapering, convinced patient, experienced multidisciplinary team and well-established patient-physician relationship were identified, and consequences were described according to the International Classification of Functioning, Disability and Health, with results predominantly found in the body functions and structures category.
Conclusion: Conceptualization of PMT for patients with CNCP creates a common ground for improving current knowledge about PMT programs and can serve as a starting point for development of future research into PMT interventions.
| Original language | English |
|---|---|
| Article number | 111784 |
| Number of pages | 17 |
| Journal | Journal of Clinical Anesthesia |
| Volume | 102 |
| DOIs | |
| Publication status | Published - Mar 2025 |
Bibliographical note
Funding Information:This work was supported by the Research Foundation Flanders (FWO-TBM project number T000222N ).
Funding Information:
This work was supported by the Research Foundation Flanders (FWO-TBM project number T000222N).Elke Wuyts and Frenn Bultinck are working on a project funded by the Research Foundation Flanders (FWO-TBM project number T000222N). Dries Ceulemans is working on a project funded by the Research Foundation Flanders (FWO-TBM project number T000821N). Lisa Goudman is a postdoctoral research fellow funded by the Research Foundation Flanders (FWO), Belgium (project number 1211425N). Maarten Moens has received speaker fees from Medtronic and is funded by the FWO (project number 1801125N). STIMULUS research group received independent research grants from Medtronic. The other authors declare no conflict of interest.
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