Perceptions of Community-Dwelling Patients on the Impact of the Discontinuation of OxyContin® on their Pain Management: A Mixed Methods Study

Abstract

Chronic pain is considered a major health problem in older adults. OxyContin®, one of the most commonly used medications for treating pain in Canada, was recently discontinued, and delisted from the Ontario Drug Formulary due to high rates of abuse associated with its use. A tamper-resistant formulation was developed by the manufacturing company to replace it. Inadequacies in the available body of literature reporting on the discontinuation process prompted this study of patient perceptions on the impact of the discontinuation of OxyContin® on personal pain control. A qualitative descriptive study was carried out to provide evidence on patients’ lived-experiences, placing particular focus on identifying any flaws within the medical infrastructure through sharing discontinuation experiences and investigating the efficacy of alternative pain medications. Chronic pain patients 45 years or older were recruited from three sites and interviewed using a semi-structured guide. Interviews were conducted with physicians to obtain their perceptions on discontinuation to develop a more comprehensive understanding of the experience from both patient and professional levels. Findings of the current study provided preliminary data illuminating several aspects of patients’ pain and medical care through the discontinuation process. The emergent themes represented both convergences and divergences between patients and their clinicians. For example, areas of divergence included the motive for discontinuation, which was condemned by most patients, but supported by all physicians. Another discrepancy was reflected in the perceived impact of discontinuance on pain control, with the majority of patients reported experiencing a negative impact while most physicians described it as being insignificant within their practice. On the other hand, perceptions of patients and physicians on their experiences overlapped giving rise to a prominent theme of the need to optimize current pain management practices. Further research is warranted to build upon the foundation generated by this study to improve understanding of shortcomings in pain management and to optimize care for patients.