Opioids and driving: education gaps in advanced cancer

Anil, Nagtha; Smallwood, Natasha; Dunn, Sadie

doi:10.1136/bmjspcare-2020-002824

Cited by 2 publications

(1 citation statement)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in cases where opioids are being considered to treat symptoms, clear communication and shared decision making are required. Clinicians should consider patients' goals and willingness to use an opioid medication, their understanding of how to take the medication correctly, and the broader impacts on their lives (including the ability to drive [118]) and other potential harms such as constipation, which is common and if severe may worsen breathlessness. When a clinician and patient with serious respiratory illness decide to trial an opioid to treat symptoms, it is essential before commencing treatment to: a) ensure all illnesses contributing to breathlessness have been optimally treated, and b) the patient has received education on non-drug, self-management approaches.…”

Section: Implementation Considerationsmentioning

confidence: 99%

European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness

Holland,

Spathis,

Marsaa

et al. 2024

Eur Respir J

View full text Add to dashboard Cite

Respiratory symptoms are ubiquitous and impair health-related quality of life in people with respiratory disease. This European Respiratory Society (ERS) task force aimed to provide recommendations for symptomatic treatment in people with serious respiratory illness.The ERS task force comprised 16 members, including representatives of people with serious respiratory illness and informal caregivers. Seven questions were formulated, six in the “Population, Intervention, Comparison, Outcome” (PICO) format, which were addressed with full systematic reviews and evidence assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). One question was addressed narratively. An “evidence-to-decision” framework was used to formulate recommendations.To treat symptoms in people with serious respiratory illness, the task force suggests the use of graded exercise therapy (conditional recommendation, low certainty of evidence); and suggests the use of a multicomponent services, handheld fan and breathing techniques (conditional recommendations, very low certainty of evidence). The task force suggests not to use opioids (conditional recommendation, very low certainty of evidence); and suggests either administering or not administering supplemental oxygen therapy (conditional recommendation, low certainty of evidence). The task force suggests that needs assessment tools may be used as part of a comprehensive needs assessment, but do not replace patient centred care and shared decision making (conditional recommendation, low certainty of evidence). The low certainty of evidence, modest impact of interventions on patient-centred outcomes, and absence of effective strategies to ameliorate cough highlight the need for new approaches to reduce symptoms and enhance wellbeing for individuals who live with serious respiratory illness.

show abstract

Section: Implementation Considerationsmentioning

confidence: 99%

European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness

Holland,

Spathis,

Marsaa

et al. 2024

Eur Respir J

View full text Add to dashboard Cite

show abstract

Driving under the influence of prescribed opioids: a qualitative study of the pharmacist's contribution to road safety

Gillett,

King,

Carroll

et al. 2024

Pharmacy Practice and Res

View full text Add to dashboard Cite

BackgroundAustralia's 20‐year consistent fall in road crash fatalities has stalled. Concerning is the marked increase of prescribed potentially driving‐impairing medications (PDIMs), led by opioids, in driver autopsies. Drivers prescribed opioids are often not well advised on cognitive impairment. Pharmacists have a potential role to provide such advice, but their experiences and opinions are generally unreported.AimTo investigate the experiences, perceptions, and opinions of pharmacists dispensing prescribed opioids to patients, particularly what specific advice is given regarding driving safety, and to explore pharmacists' potential future role.MethodTen pharmacists in the regional city of Toowoomba, Queensland, consented to semi‐structured interviews, conducted between November 2019–November 2021. Interviews were then transcribed and subjected to reflexive thematic analysis to identify themes from the pharmacists' responses. This study is part of a broader project: How do doctors and pharmacists perceive their roles in ensuring safety in driving for both the patient and the general community? Ethical approval was granted by the Queensland University of Technology Research Ethics Committee (Reference no: 1900000374) and the study conforms to Australian National statement on ethical conduct in human research. Informed consent was obtained from all participants via completion of a written consent form after detailed project information was provided. This occurred at least 5 days after participants were first approached.ResultsThree main themes emerged: road safety versus freedom and independence, team approach and communication with general practitioners (GPs), and varying scope of advice on opioid impairment and tolerance. Pharmacists are aware of potential impacts on road safety, yet they are sympathetic towards the independence driving affords. GP communication and a team approach with GPs were the strongest subthemes. Pharmacists gave good information about cognitive impairment without specifically referencing driving. Pharmacists' learning about medications and driving occurred only “on the job.”ConclusionPharmacists' current advice to opioid‐medicated drivers (OMDs) would benefit from focused opioid upskilling empowering OMDs to make rational driving decisions. A more team‐oriented interaction, marked by better communication between pharmacists and GPs, should result in improved road safety among OMDs.

show abstract

Opioids and driving: education gaps in advanced cancer

Cited by 2 publications

References 9 publications

European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness

European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness

Driving under the influence of prescribed opioids: a qualitative study of the pharmacist's contribution to road safety

Contact Info

Product

Resources

About