Table 6 Statistics-by-theme Joint Display of Participant Acceptability of PROMPPT
PROMPPT acceptability domain | Acceptability questionnaire (n = 63) | Qualitative framework summary | Inference |
|---|---|---|---|
Global acceptability | Acceptable or completely acceptable N = 45 (90%) | Overall PROMPPT review is a good idea, appropriate, and something to be recommended • Participants reported the review was in no way problematic and not missing anything | Confirmation |
Affective attitude | Like or strongly like the review N = 38 (76%) | Varied emotional responses to the review • Pre-review, some participants were pleased, grateful, and happy with prospect of seeing a pharmacist. Others were unsure, worried, and concerned about the possible outcome of the review and impact on health and wellbeing • Post-review, most participants were happy and would recommend the review, but some felt abandoned by the GP and were disappointed with follow-up | Expansion |
Burden | Review took no effort at all or little effort N = 44 (88%) | Little or no effort required to participate in the review • Benefits of face-to-face consultations outweighed any burden of attending in person • Discussions were straightforward overall, except for some participants who were happy with current pain medicine regime | Confirmation |
Ethicality | Fair or very fair N = 42 (84%) | It is fair and right to proactively invite patients with persistent pain to a review if uptake is voluntary, and patients should also be able to request a review | Confirmation |
Intervention coherence | Agree or strongly agree with purpose of PROMPPT and how it works N = 33 (66%) | Initial perceptions of the purpose of PROMPPT varied • For some, PROMPPT was seen as something different, an opportunity to talk, reflect, think differently about medication use, weigh up positives and negatives, and get reassurance • Some participants hoped to get pain relief as current medicines were not working and were looking for a cure rather than other ways of living well with pain • Relevance of the review for all patients was questioned by some participants. Some felt it was important for ‘people earlier on’ when they had not tried many options. Participants who were stable and happy with their current pain medication were unsure of the benefit • Although there were some examples of increased knowledge, unmet information needs remained after the review | Expansion |
Opportunity costs | Strongly disagree or disagree there was interference with priorities n = 24 (48%) No opinion n = 14 (28%) | Booking and attending a PROMPPT review did not impact on other participant priorities | Dissonance |
Self-efficacy | Confident or very confident to make changes n = 34 (68%) | Participants expressed confidence in taking part in the review and having discussions with the pharmacist • Developing a good relationship with the pharmacist supported confidence in the review and any changes suggested • Having previous positive experiences consulting with the pharmacist contributed towards this feeling of trust and confidence • Knowing that pharmacists were qualified and had extra training on medicines contributed towards this feeling of trust and confidence • Confidence in implementing changes varied. Some were happy with making changes, whereas others were more hesitant and expressed a desire for additional support to implement the plan suggesting unmet needs | Expansion |
Perceived effectiveness | Agree or strongly agree the review will change pain management n = 30 (60%) | Few participants anticipated the review’s effectiveness. It was only after experiencing the review that participants could see the potential benefit • Some felt that the review’s goal should not be to remove opioids completely, as there was a place for pain medication to be able to function • Participants were generally happy with the suggested changes. Most reported no change in pain as a result, and one experienced an improvement • Some participants reported other benefits of the review, for example: learning that their current pain medicines were the right ones for them (reassurance & confidence), appreciating having a clinician to discuss their pain management with, gaining knowledge about pain medicines with, and one participant reported being motivated to ‘dig out’ their pain management and CBT booklets and revisit previous strategies • Despite this, some participants felt the impact of the review was minimal. Some felt it was neither helpful nor useful to them personally but had potential for others • Only one expressed dissatisfaction with the suggested reduction having experienced withdrawal and self-reinstated back to his higher dose | Expansion |