Table 7 Statistics-by-theme Joint Display of Fidelity of PROMPPT Delivery
Key PROMPPT intervention component | Case report form (n = 80) | Audio-recorded consultation (n = 8) | Qualitative framework summary | Inference |
|---|---|---|---|---|
1. Inviting patients to tell their pain story | 100% (n = 80) | 100% (n = 8) | Mixed experiences of storytelling • Some participants managed to discuss everything they wanted and felt comfortable sharing their ‘pain story’ • Others did not get the opportunity to discuss pain experience, despite expecting pharmacists to ask them | Dissonance |
2. Using the Pain Concerns Form | 99% (n = 79) | 100% (n = 8) | Most participants did not recall the Pain Concerns Form being used during the review | Dissonance |
3. Exploring the effects of opioids | 89% (n = 71) | 100% (n = 8) | Mixed experiences of discussing the effects of opioids • Some described discussions with the pharmacist about side effects and being asked if they were experiencing problems • Others felt that side effects were not discussed, were not sure if they were, or could not remember them being discussed • Some participants did not know what the potential side effects and risks of opioids were, highlighting missed opportunities for pharmacists to talk more about potential harms | Expansion |
4. Assessing patients’ perspective on changing opioids | 98% (n = 78) | 88% (n = 7) | Evaluating how well pharmacists assessed the patient’s perspective on changing opioids was difficult to determine from the patient interviews | - |
5. Discussing self-management for persistent pain | 64% (n = 51) | 75% (n = 6) | Many participants felt that self-management, living well with pain, and doing other things to help with their pain were not discussed at the review • Some recalled discussions about exercise, keeping moving, weather, sleep, diet, and relaxation/meditation | Agreement |
6. Discussed management plan | 85% (n = 68) | 63% (n = 5) | • Participants talked about a range of plans to make changes to their opioid and non-opioid pain medication • Some talked about how they had agreed not to make changes to their opioid medication • Most discussed being actively involved in discussions and decisions around changing their opioids medicines however some described a lack of collaboration with the pharmacist already having a plan | Agreement and expansion |
7. Pain review plan and written resources | 66% (n = 53) | 75% (n = 6) | • Most participants said that they did not receive a pain review plan or any written information or leaflets after the review • One received a blank pain review plan, whilst others had received it but were yet to look at it or had forgotten about it | Agreement |
8. Further contact arrangements discussed | 68% (n = 54) | 88% (n = 7) | Experiences of follow-up varied • Some participants had a follow-up booked at the time of the interview and knew they could contact the pharmacist anytime, providing reassurance to them about making changes • Half of patients did not remember discussing, or did not discuss follow-up • Some were waiting for follow-up to be arranged but were not sure how this would happen | Agreement and expansion |