Opioid-Related Transition Experiences of Patients With Rheumatic Disease: A Qualitative Study

This study aimed to comprehensively describe patient experiences with opioid-related transitions (OrTs) and identify modifiable gaps in care to improve pain management for individuals with rheumatic disease (RD).

We conducted a qualitative descriptive study with 20 participants with RD who had used prescribed opioids in the past year. Semistructured interviews were analyzed using conventional content analysis.

We identified four themes. The first, "managing together, deciding alone," included the following subthemes: (a) clinician guidance in opioid use decision-making, (b) family involvement in opioid decision-making and advocacy, (c) self-directed opioid use strategies, and (d) risk-reduction strategies to prevent opioid addiction, dependence, and tolerance. The second, "turbulence of opioid medication changes," included the following subthemes: (a) evolving and dynamic opioid regimens, (b) disrupted access to opioid medications, and (c) the toll of opioid medication changes. The third, "transitions across opioid prescribers," included the following subthemes: (a) context of opioid prescriber changes, (b) drivers of opioid prescriber changes, (c) navigating opioid prescriber changes, and (d) reassurance of trusting relationships during opioid prescriber changes. The fourth, "opioid transitions across care settings," included the following subthemes: (a) shifts in opioid management across care settings, (b) home to hospital transitions: delayed access and needed advocacy, and (c) hospital to home transitions: adequacy, engagement, and unmet needs.

Patients with RD frequently experience OrTs across multiple clinicians and care settings. Findings highlight the complexity, risks, patient burden, and suboptimal outcomes associated with these transitions and underscore the need for improved care coordination and innovative support.