Pharmacist experience with providing care for patients with chronic pain in the community setting: A qualitative study

Abstract

Objectives: Chronic pain is a condition pharmacists frequently encounter in practice; however, the pharmacist’s role in the management of chronic pain is under-investigated. This study examines pharmacist perceptions and experiences in providing care to patients with chronic pain in the community setting. Methods: Practicing primary care pharmacists in Ontario were recruited and interviewed using a semi-structured guide. Interviews were analyzed using modified grounded theory. Sample recruitment continued until saturation was achieved. Results: Twelve pharmacists responded to the email invitation. Two did not meet eligibility criteria and one withdrew. The sample consisted of 6 female and 3 male pharmacists with a mean age of 47 years (range: 27 – 63) and mean of 20 years (range: 2 – 40) of practice. Five themes emerged from the content analysis: (1) perception of chronic pain (2) concern about opioid use (3) lack of support for patients, (4) communication with prescribers, and (5) knowledge gaps. Participants were comfortable with their knowledge of chronic pain and were empathetic of their patients’ suffering. They also felt their role is limited within the current healthcare system. Participants reported that misuse of opioids is the most challenging; issues included high potential for misuse, inadequate monitoring and under-use of other medications and resources for the treatment of chronic pain. Additionally, participants believed that patients suffer from lack of support by their family, employers and the health care system. Furthermore, trust was identified as the most important parameter in building a collaborative relationship with physicians. Finally, participants felt more training on legal issues related to opioids is required. Conclusion: Pharmacists were empathetic towards patients with chronic pain; however, they felt their role is limited in current climate. Deficiencies in the current system of managing chronic pain were identified including opioid use as the most challenging. Future research should investigate expansion of pharmacist roles to optimize chronic pain management.