A Conceptual Framework for Understanding Unintended Prolonged Opioid Use.

Area of Science:

• Medical Research
• Public Health
• Clinical Practice

Background:

• Unintended prolonged opioid use (UPOU) presents a significant public health challenge.
• A deeper understanding of the transition from short-term to prolonged opioid use is urgently needed.

Purpose of the Study:

• To propose a conceptual framework for understanding UPOU.
• The framework identifies three principal domains influencing UPOU: individual patients, the practice environment, and opioid prescribers.

Main Methods:

• The study proposes a conceptual framework, a process involving evidence synthesis and expert opinion.
• Factors within each domain were identified and their relationships to UPOU were considered.
• A graphic depiction of the framework illustrates the interplay of these factors.

Main Results:

• Patient characteristics include medical/mental health conditions, pain etiology, individual reactions to pain/opioids, and sociodemographics.
• Practice environment factors encompass structural and policy elements, including healthcare guidelines and regulatory environments.
• Prescriber characteristics involve training, attitudes, knowledge, beliefs, and professionalism, all influencing opioid prescribing behavior.

Conclusions:

• The proposed conceptual framework integrates patient, practice, and prescriber domains to explain UPOU.
• This framework can guide future research and the development of targeted interventions to mitigate UPOU.
• Understanding the interaction of these domains is crucial for reducing the incidence of unintended prolonged opioid use.