The first step in co-design of a digital brief intervention to reduce prescription opioid related harm, informed by patient lived experiences: A qualitative analysis (Preprint)

BACKGROUND Opioid medications are important in pain management. Despite this, many patients progress to unsafe medication use. With few personalized and accessible behavioral treatment options to reduce opioid-related harm, new and innovative approaches are urgently needed to fill this gap. Co-design methods offers an opportunity to put patient partners at the centre of the solution. OBJECTIVE This study involved the first phase of co-design of a digital brief intervention (BI) to reduce opioid-related harm – investigating the lived experience of chronic non-cancer pain (CNCP) in treatment-seeking patients with a particular focus on opioid therapy experiences. METHODS Eligible patients were aged 18-70 years, with CNCP at clinically significant intensity (> 4/10). Purposive sampling was used to engage patients on public hospital wait lists via mail, or the treating medical specialist. Participants (N = 18; 10 women; Mage = 49.5+/- SD years) completed semi-structured phone interviews. Interviews were transcribed verbatim, thematically analysed using grounded theory and member checked by patients. RESULTS Eight overarching themes were found (mostleast prominent): Limited treatment collaboration and partnership; Limited biopsychosocial understanding of pain; Continued opioid use when benefits don’t outweigh harms; Trial and error approach to opioid use; Cycles of hopefulness and hopelessness; Diagnostic uncertainty; Significant negative impacts tied to loss; and Complexity of pain and opioid journeys. CONCLUSIONS This study advances progress in co-design of digital BIs by actively engaging patient partners in their lived experiences. Key recommendations for consideration in the co-design process should guide personalized solutions to address the complex care needs of patients with CNCP.