Intensive & critical care nursing · 2025
Stakeholder perspectives on the reduction of opioid exposure in ICU: A modified Delphi survey.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Du Toit Lize-Mari, Bagshaw Sean M, Basmaji John, Chaudhuri Dipayan, Duquette D'Arcy, Fiest Kirsten M, Honarmand Kimia, Karvellas Constantine J, Kilcommons Sebastian, Kutsogiannis Demetrios James, Lewis Kimberley, Lynam Deborah E, Ma Chen-Hsiang, Mehta Sangeeta, Oxland Peter, Parker Arabesque, Rewa Oleksa, Rochwerg Bram, Senaratne Janek, Sharif Sameer, Sligl Wendy, Stelfox Henry T, Tworek Kimberly B, Zampieri Fernando G, Lau Vincent I
Аннотация
PURPOSE: The global opioid epidemic highlights the need to re-evaluate pain management strategies and find alternatives to minimize opioid exposure. Opioids are primary analgesics and sedatives in intensive care units (ICUs) but may have negative consequences for patients and families. This study aimed to identify key patient-important outcomes related to opioid reduction and the use of analgesic adjuncts (e.g., non-steroidal anti-inflammatory drugs [NSAIDs]) in critically ill adult patients through a modified Delphi study involving patients, families, and healthcare providers.
METHODS: A modified Delphi process, including two survey rounds and one discussion round among stakeholders (patients, family members, and healthcare providers), was used to identify and rate key patient-important outcomes, evaluation time-points, and suitable tools/definitions for a potential randomized controlled trial.
RESULTS: Opioid reduction was identified as a key patient-important outcome by 82% of participants across both survey rounds. Various themes emerged from surveys and stakeholder meetings, showing a preference for both pharmacological and non-pharmacological adjunctive therapies for ICU pain management. Opinions varied based on clinical or non-clinical backgrounds.
CONCLUSIONS: Participants agreed that reducing opioid exposure and using adjunctive pain management strategies are crucial patient-important outcomes. Further research is needed to explore the efficacy and safety of opioid alternatives and both pharmacologic and non-pharmacologic interventions.
IMPLICATIONS FOR CLINICAL PRACTICE: This study highlights that both patients and families value reducing opioid exposure and exploring alternatives, aligning with healthcare providers' goals. Improved communication and education about opioid use can enhance patient-centered care. These findings support the need for future trials on adjunctive analgesics to reduce opioid exposure and improve outcomes, addressing both clinical and patient-family perspectives.
METHODS: A modified Delphi process, including two survey rounds and one discussion round among stakeholders (patients, family members, and healthcare providers), was used to identify and rate key patient-important outcomes, evaluation time-points, and suitable tools/definitions for a potential randomized controlled trial.
RESULTS: Opioid reduction was identified as a key patient-important outcome by 82% of participants across both survey rounds. Various themes emerged from surveys and stakeholder meetings, showing a preference for both pharmacological and non-pharmacological adjunctive therapies for ICU pain management. Opinions varied based on clinical or non-clinical backgrounds.
CONCLUSIONS: Participants agreed that reducing opioid exposure and using adjunctive pain management strategies are crucial patient-important outcomes. Further research is needed to explore the efficacy and safety of opioid alternatives and both pharmacologic and non-pharmacologic interventions.
IMPLICATIONS FOR CLINICAL PRACTICE: This study highlights that both patients and families value reducing opioid exposure and exploring alternatives, aligning with healthcare providers' goals. Improved communication and education about opioid use can enhance patient-centered care. These findings support the need for future trials on adjunctive analgesics to reduce opioid exposure and improve outcomes, addressing both clinical and patient-family perspectives.