Challenges of treating patients with chronic pain with dysphagia (CPD): physician and patient perspectives

Abstract

A proportion of patients with chronic pain have dysphagia and cannot swallow solid, oral dosage forms, which creates a serious treatment challenge for pain specialists and other healthcare providers. Currently available treatment options have limitations; new treatment options would be welcomed by both physicians and patients. Physician and patient education should be enhanced in order to promote awareness of the deleterious consequences associated with altering currently available analgesic formulations. Facilitating patient-physician communication on this topic may help to improve treatment outcomes.

The knowledge, attitudes and beliefs of patients and their healthcare professionals around oral dosage form modification: A systematic review of the qualitative literature

“…The views of HCPs were examined in three of the studies: one study included nurses, 34 one included physicians 35 and one included a mixed sample of HCPs. 36 The remaining four studies investigated the views of patients.…”

“…[37][38][39][40] All of the studies involving HCPs were directly related to the topic of this review. [34][35][36] For the studies involving patients, one study directly addressed the topic of interest. 38 Of the remaining three studies undertaken in patient cohorts, two investigated the problems experienced by patients in managing their medication 39,40 while one examined factors related to adherence.…”

“…Modifications to facilitate fractional dosing were discussed in three of the studies, 37,39,40 while modifications for swallowing difficulties were the topic of consideration for four of the studies. [34][35][36]38 M A N U S C R I P T …”

“…All of the studies provided a clear statement of the aims of the research, used qualitative methodology appropriately, and employed an appropriate research design and recruitment strategy. Three of the studies did not provide sufficient detail about data collection 35,36,39 , with two of the studies not discussing data saturation 35,36 and one not providing detail about the use of a topic guide. 39 Four of the studies did not address reflexivity which relates to the researcher considering their role and potential bias.…”

“…[34][35][36]39 Two of the studies did not provide sufficient detail about the data analysis process, particularly in relation to the number of researchers who performed the analysis. 35,36 Finally, one study did not state whether ethical approval had been obtained, did not provide participant quotes to substantiate findings or discuss in detail the findings in light of existing evidence or the implications for practice. 39 Pergolizzi Jr et al 35 Tordoff et al 40 Clearly stated aim(s)?…”