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Improving the management of chronic pain using mixed methods and an analytical framework to make recommendations for improving services

Methods: Three research methodologies were used including a comprehensive literature review, a descriptive study and a qualitative study.  A revised root cause analysis framework (consisting of four major steps) adapted and created by the researcher was also applied as an analytical framework to the whole research programme to facilitate the achievement of the aim and objectives. Results: Antidepressants were the most commonly prescribed drugs followed by a combination of paracetamol and weak opioids.  Drug-drug interactions between antidepressants and opioids were the most common potential MRPs.  Analgesic prescribing was independently associated with cause of pain and health-related quality of life.  Pain level, cause of pain and health-related quality of  life were independent significant factors for adjuvant prescribing.  The poorer the health-related quality of life was, the greater the number of analgesics and adjuvant drugs that were prescribed.  A  model of pain medication taking behaviours was developed, and relationships between MRPs, pain medication taking behaviours and considerations of patients’ perspectives on pain and pain medication taking were identified.  Patient factors were the main root causes of complex MRPs.   A set of recommendations (for both GPs and pharmacists) and evidence-derived questions for primary care pharmacists were proposed to help reduce and prevent MRPs. Conclusion: An intervention based on the findings of this study, and related to the pharmacist’s roles and responsibility could ultimately help to improve pharmaceutical care services for people with chronic pain in primary care.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:531872
Date January 2010
CreatorsKittiboonyakun, Pattarin
PublisherUniversity of Aberdeen
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttp://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=158345

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