- Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain 2020;161:1976–82.32694387
- Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019;160:19–27.30586067
- Vos T, Allen C, Arora M. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1211–59.28919117
- Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open 2016;6:e010364.
- Yu D, Peat G, Jordan KP, Bailey J, Prieto-Alhambra D, Robinson DE, et al. Estimating the population health burden of musculoskeletal conditions using primary care electronic health records. Rheumatology (Oxford) 2021;60:4832–43.33560340
- NHS Digital. Health Survey for England 2017. London: NHS Digital; 2018.
- Christie MJ. Cellular neuroadaptations to chronic opioids: tolerance, withdrawal and addiction. Br J Pharmacol 2008;154:384–96.18414400
- Tompkins DA, Campbell CM. Opioid-induced hyperalgesia: clinically relevant or extraneous research phenomenon? Curr Pain Headache Rep 2011;15:129–36.21225380
- Els C, Jackson TD, Hagtvedt R, Kunyk D, Sonnenberg B, Lappi VG, Straube S. High‐dose opioids for chronic non‐cancer pain: an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017;10:CD012299.
- ChouDana T, Bougatsos C, Deyo RA, Turner R, Devine JA, Hansen EB, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med 2015;162:276–86.25581257
- International Association for Study of Pain. IASP Statement on Opioids for Pain Management. 2018. URL: www.iasp-pain.org/advocacy/iasp-statements/opioids-for-pain-management/?navItemNumber=7225 (accessed April 2023).
- GuyMurphy LB, Dowell D, Zhang GP Jr, Bohm K, Losby MK, Lewis J, et al. Vital signs: changes in opioid prescribing in the United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017;66:697–704.28683056
- Curtis HJ, Croker R, Walker AJ, Richards GC, Quinlan J, Goldacre B. Opioid prescribing trends and geographical variation in England, 1998–2018: a retrospective database study. Lancet Psychiatry 2019;6:140–50.30580987
- Royal Australian College of General Practitioners. Australian GPs Call for Reform in Pain Management to Protect Patients and Reduce Risky Opioid Use [Press Release]. Melbourne, VIC: Royal Australian College of General Practitioners; 2017.
- Jani M, Yimer B, Sheppard T, Lunt M, Dixon WG. Birlie Time trends and prescribing patterns of opioid drugs in UK primary care patients with non-cancer pain: a retrospective cohort study. PLOS Med 2020;17:e1003270.33057368
- Centers for Disease Control and Prevention. Vital signs: overdoses of prescription opioid pain relievers – United States, 1999–2008. MMWR Morb Mortal Wkly Rep 2011;60:1487–92.22048730
- Almeida M, Saragiotto B, Richards B, Maher CG. Primary care management of non-specific low back pain: key messages from recent clinical guidelines. Med J Aust 2018;208:272–5.29614943
- National Institute for Health and Care Excellence. Chronic Pain (Primary and Secondary) in over 16s: Assessment of All Chronic Pain and Management of Chronic Primary Pain. NG193. Manchester: National Institute for Health and Care Excellence; 2021.
- NHS England. The National Patient Safety Improvement Programmes. 2021. URL: www.england.nhs.uk/patient-safety/patient-safety-improvement-programmes/#MedSIP (accessed April 2023).
- Faculty of Pain Medicine. Opioid Aware. Updated January 2022. URL: www.fpm.ac.uk/opioids-aware (accessed April 2023).
- EcclestonKnaggs R, Moore RA, Fisher C, Thomas E, Hearn KH, Derry L, et al. Interventions for the reduction of prescribed opioid use in chronic non-cancer pain. Cochrane Database Syst Rev 2017;11:CD010323.
- Frank JW, Lovejoy TI, Becker WC, Morasco BJ, Koenig CJ, Hoffecker L, et al. Patient outcomes in dose reduction or discontinuation of long-term opioid therapy: a systematic review. Ann Intern Med 2017;167:181–91.28715848
- Fishbain DA, Pulikal A. Does opioid tapering in chronic pain patients result in improved pain or same pain vs increased pain at taper completion? A structured evidence-based systematic review. Pain Med 2019;20:2179–97.30597076
- NHS National Patient Safety Improvement Programmes. Improving Chronic Pain Management by Reducing Harm from Opioids: Report on an Analysis of Published Literature and Real-World Case Studies from across England. London: NHS England; 2021.
- Williamson TB, Nelson HW. Reply to the comment by Wellstead et al. on “Barriers to enhanced and integrated climate change adaptation and mitigation in Canadian forest management”. Can J Forest Res 2018;48:1246–50. 10.1139/cjfr-2018-0205
- Cross AJ, Buchbinder R, Mathieson S, Bourne A, Maher CG, Lin CC, O'Connor DA. Barriers and enablers to monitoring and deprescribing opioid analgesics for chronic non-cancer pain: a systematic review with qualitative evidence synthesis using the Theoretical Domains Framework. BMJ Qual Saf 2022;31:387–400.
- Mordecai L, Reynolds C, Donaldson LJ, de C Williams AC. Patterns of regional variation of opioid prescribing in primary care in England: a retrospective observational study. Br J Gen Pract 2018;68:e225–33.29440012
- Centre for Reviews and Dissemination. Systematic Reviews. CRD’s Guidance for Undertaking Reviews in Health Care. York: University of York; CRD; 2009.
- Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 2008;8:45.18616818
- Stern C, Lizarondo L, Carrier J, Godfrey C, Rieger K, Salmond S, et al. Methodological guidance for the conduct of mixed methods systematic reviews. JBI Evid Implement 2021;19:120–9.34061049
- Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71.33782057
- Booth A, Harris J, Croot E, Springett J, Campbell F, Wilkins E. Towards a methodology for cluster searching to provide conceptual and contextual ‘richness’ for systematic reviews of complex interventions: case study (CLUSTER). BMC Med Res Methodol 2013;13:118.24073615
- Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016;5:210.27919275
- Booth A, Cleyle S. Clear and present questions: formulating questions for evidence based practice. Libr Hi Tech 2006;24:355–68.
- O’Neill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M, et al. Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. J Clin Epidemiol 2014;67:56–64.24189091
- Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898.31462531
- Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al.; Cochrane Bias Methods Group. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.22008217
- Critical Appraisal Skills Programme. CASP Cohort Study Checklist. 2022. URL: https://casp-uk.net/casp-tools-checklists/ (accessed April 2023).
- Critical Appraisal Skills Programme. CASP Qualitative Checklist. 2020. URL: https://casp-uk.net/casp-tools-checklists/ (accessed April 2023).
- Critical Appraisal Skills Programme. CASP Randomised Controlled Trial Checklist. 2020. URL: https://casp-uk.net/casp-tools-checklists/ (accessed April 2023).
- Long HA, French DP, Brooks JM. Optimising the value of the critical appraisal skills programme (CASP) tool for quality appraisal in qualitative evidence synthesis. Res Methods Med Health Sci 2020;1:31–42.
- Pollock A, Campbell P, Cheyne J, Cowie J, Davis B, McCallum J, et al. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev 2020;11:CD013779.
- Colvin CJ, Garside R, Wainwright M, Munthe-Kaas H, Glenton C, Bohren MA, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence. Implement Sci 2018;13:13.29384081
- Glenton C, Carlsen B, Lewin S, Munthe-Kaas H, Colvin CJ, Tunçalp O, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 5: how to assess adequacy of data. Implement Sci 2018;13:14.29384077
- Lewin S, Bohren M, Rashidian A, Munthe-Kaas H, Glenton C, Colvin CJ, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a summary of qualitative findings table. Implement Sci 2018;13:10.29384082
- Munthe-Kaas H, Bohren MA, Glenton C, Lewin S, Noyes J, Tunçalp O, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations. Implement Sci 2018;13:9.29384078
- Noyes J, Booth A, Lewin S, Carlsen B, Glenton C, Colvin CJ, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data. Implement Sci 2018;13:4.29384080
- Thompson W, Reeve E. Deprescribing: moving beyond barriers and facilitators. Res Social Adm Pharm 2022;18:2547–9.33867278
- Booth A, Carroll C. Systematic searching for theory to inform systematic reviews: is it feasible? Is it desirable? Health Info Libr J 2015;32:220–35.26095232
- Noyes J, Hendry M, Booth A, Chandler J, Lewin S, Glenton C, Garside R. Current use was established and Cochrane guidance on selection of social theories for systematic reviews of complex interventions was developed. J Clin Epidemiol 2016;75:78–92.26772607
- Graham-Rowe E, Lorencatto F, Lawrenson JG, Burr JM, Grimshaw JM, Ivers NM, et al. Barriers to and enablers of diabetic retinopathy screening attendance: a systematic review of published and grey literature. Diabet Med 2018;35:1308–19.29790594
- Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 2012;7:37.22530986
- Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A; 'Psychological Theory' Group. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care 2005;14:26–33.15692000
- Michie S, Johnston M, Francis J, Hardeman W, Eccles M. From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques. Appl Psychol 2008;57:660–80.
- Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18.23496984
- Voorhees J, Bailey S, Waterman H, Checkland K. Accessing primary care and the importance of ‘human fit’: a qualitative participatory case study. Br J Gen Pract 2022;72:e342–50.34990392
- Bhattacharya D, Whiteside H, Tang E, Kantilal K, Loke Y, Atkins B, Hill C. A review of trial and real-world data applying elements of a realist approach to identify behavioural mechanisms supporting practitioners to taper opioids. Br J Clin Pharmacol 2022;88:4019–42.35561033
- Desveaux L, Saragosa M, Kithulegoda N, Ivers NM. Understanding the behavioural determinants of opioid prescribing among family physicians: a qualitative study. BMC Fam Pract 2019;20:59.31077137
- Atkins L, Francis J, Islam R, O’Connor D, Patey A, Ivers N, et al. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implement Sci 2017;12:77.28637486
- Bronfenbrenner U. Ecological Systems Theory. In Vasta R, editor. Annals of Child Development, vol. 6. London: Jessica Kingsley Publishers; 1989. pp. 187–249.
- National Institute for Health and Care Excellence. Developing NICE Guidelines: The Manual. URL: www.nice.org.uk/process/pmg20/chapter/introduction (accessed April 2023).
- HamiltonBlyth F, Mathieson S, Gnjidic M, Christine Lin D, Jansen CW, Weir J, et al. Opioid deprescribing: qualitative perspectives from those with chronic non-cancer pain. Res Social Adm Pharm 2022;18:4083–91.35963766
- Hamilton M, Mathieson S, Gnjidic D, Jansen J, Weir K, Shaheed CA, et al. Barriers, facilitators, and resources to opioid deprescribing in primary care: experiences of general practitioners in Australia. Pain 2022;163:e518–26.33990105
- Schneider JL, Firemark AJ, Papajorgji-Taylor D, Reese KR, Thorsness LA, Sullivan MD, et al. ‘I really had somebody in my corner’. Patient experiences with a pharmacist-led opioid tapering program. J Am Pharm Assoc 2022;63:241–51.e1.
- Kosakowski S, Benintendi A, Lagisetty P, Larochelle MR, Bohnert ASB, Bazzi AR. Patient perspectives on improving patient-provider relationships and provider communication during opioid tapering. J Gen Intern Med 2022;37:1722–8.34993861
- Austin RC, Fusco CW, Fagan EB, Drake E, Pacious J, Dickens H, et al. Teaching opioid tapering through guided instruction. Fam Med 2019;51:434–7.31081916
- Bienek N, Maier C, Kaisler M, Michel-Lauter B, Schwarzer A, Meyer-Friesem CH. Intensity of withdrawal symptoms during opioid taper in patients with chronic pain-individualized or fixed starting dosage? Pain Med 2019;20:2438–49.30806672
- Cunningham JL, Evans MM, King SM, Gehin JM, Loukianova LL. Opioid tapering in fibromyalgia patients: experience from an interdisciplinary pain rehabilitation program. Pain Med 2016;17:1676–85.26755658
- Garland EL, Manusov EG, Froeliger B, Kelly A, Williams JM, Howard MO. Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial. J Consult Clin Psychol 2014;82:448–59.24491075
- Gersch WD, Delate T, Bergquist KM, Smith K. Clinical effectiveness of an outpatient multidisciplinary chronic pain management telementoring service. Clin J Pain 2021;37:740–6.34265787
- Hudak J, Hanley AW, March RW, Nakamura Y, Yabko B, et al. Endogenous theta stimulation during meditation predicts reduced opioid dosing following treatment with mindfulness-oriented recovery enhancement. Neuropsychopharmacology 2020;46:836–43.32919401
- Huffman KL, Rush TE, Fan Y, Sweis GW, Vij B, Covington EC, et al. Sustained improvements in pain, mood, function and opioid use post interdisciplinary pain rehabilitation in patients weaned from high and low dose chronic opioid therapy. Pain 2017;158:1380–94.28328578
- Jacobs SC, Son EK, Tat C, Chiao P, Dulay M, Ludwig A. Implementing an opioid risk assessment telephone clinic: outcomes from a pharmacist-led initiative in a large Veterans Health Administration primary care clinic, December 15, 2014–March 31, 2015. Subst Abus 2016;37:15–9.26675444
- Krumova EK, Bennemann P, Kindler D, Schwarzer A, Zenz M, Maier C. Low pain intensity after opioid withdrawal as a first step of a comprehensive pain rehabilitation program predicts long-term nonuse of opioids in chronic noncancer pain. Clin J Pain 2013;29:760–9.23567163
- Kurita GP, Hojsted J, Sjogren P. Tapering off long-term opioid therapy in chronic non-cancer pain patients: a randomized clinical trial. Eur J Pain 2018;22:1528–43.
- Laigaard J, Bache N, Stottmeier S, Mathiesen O, Estrup S. Cognitive function during opioid tapering in patients with chronic pain: a prospective cohort study. J Pain Res 2020;13:3385–94.33363405
- Montgomery AD, Ottenbacher R. Battlefield acupuncture for chronic pain management in patients on long-term opioid therapy. Med Acupunct 2020;32:38–44.32110262
- Murphy JL, Clark ME, Banou E. Opioid cessation and multidimensional outcomes after interdisciplinary chronic pain treatment. Clin J Pain 2013;29:109–17.22751033
- Panicker L, Prasun MA, Stockmann C, Simon J. Evaluation of chronic, noncancer pain management initiative in a multidisciplinary pain clinic. Pain Manag Nurs 2022;23:122–7.34756689
- Rivich J, McCauliff J, Schroeder A. Impact of multidisciplinary chart reviews on opioid dose reduction and monitoring practices. Addict Behav 2018;86:40–3.29752012
- Seal KH, Rife T, Li Y, Gibson C, Tighe J. Opioid reduction and risk mitigation in VA primary care: outcomes from the integrated pain team initiative. J Gen Intern Med 2020;35:1238–44.31848861
- Sharp AL, Shen E, Wu YL, Wong A, Menchine M, Kanter MH, et al. Satisfaction with care after reducing opioids for chronic pain. Am J Manag Care 2018;24:e196–9.29939510
- Thakral M, Walker RL, Saunders K, Shortreed SM, Dublin S, Parchman M, et al. Impact of opioid dose reduction and risk mitigation initiatives on chronic opioid therapy patients at higher risk for opioid-related adverse outcomes. Pain Med 2018;19:2450–8.29220525
- Von Korff M, Dublin S, Walker RL, Parchman M, Shortreed SM, Hansen RN, et al. The impact of opioid risk reduction initiatives on high-dose opioid prescribing for patients on chronic opioid therapy. J Pain 2016;17:101–10.26476264
- Von Korff M, Walker RL, Saunders K, Shortreed SM, Thakral M, Parchman M, et al. Prevalence of prescription opioid use disorder among chronic opioid therapy patients after health plan opioid dose and risk reduction initiatives. Int J Drug Policy 2017;46:90–8.28666143
- Sherman KJ, Walker RL, Saunders K, Shortreed SM, Parchman M, Hansen RN, et al. Doctor-patient trust among chronic pain patients on chronic opioid therapy after opioid risk reduction initiatives: a survey. J Am Board Fam Med 2018;31:578–87.29986984
- Thakral M, Walker RL, Saunders K, Shortreed SM, Parchman M, Hansen RN, et al. Comparing pain and depressive symptoms of chronic opioid therapy patients receiving dose reduction and risk mitigation initiatives with usual care. J Pain 2018;19:111–20.29038060
- Townsend CO, Kerkvliet JL, Bruce BK, Rome JD, Hooten WM, Luedtke CA, et al. A longitudinal study of the efficacy of a comprehensive pain rehabilitation program with opioid withdrawal: comparison of treatment outcomes based on opioid use status at admission. Pain 2008;140:177–89.18804915
- Twillman RK, Hemmenway N, Passik SD, Thompson CA, Shrum M, DeGeorge MK. Impact of opioid dose reduction on individuals with chronic pain: results of an online survey. J Pain Res 2018;11:2769–79.30519080
- Zhou K, Jia P, Bhargava S, Zhang Y, Reza T, Peng YB, Wang GG. Opioid tapering in patients with prescription opioid use disorder: a retrospective study. Scand J Pain 2017;17:167–73.28988103
- Caldera FE. Medical cannibus as an alternative for opioids for chronic pain: a case report. SAGE Open Med Case Rep 2020;8:907015.
- Lalanne L, Nicot C, Lang JP, Bertschy G, Salvat E. Experience of the use of Ketamine to manage opioid withdrawal in an addicted woman: a case report. BMC Psychiatry 2016;16:395.27832755
- Benintendi A, Kosakowski S, Lagisetty P, Larochelle M, Bohnert ASB, Bazzi AR. ‘I felt like I had a scarlet letter’: recurring experiences of structural stigma surrounding opioid tapers among patients with chronic, non-cancer pain. Drug Alcohol Depend 2021;222:108664.33757709
- Firemark AJ, Schneider JL, Kuntz JL, Papajorgji-Taylor D, Dickerson JF, Thorsness LA, et al. ‘We need to taper’ interviews with clinicians and pharmacists about use of a pharmacy-led opioid tapering program. Pain Med 2021;22:1213–22.33616160
- Kuntz JL, Dickerson JF, Schneider JL, Firemark AJ, Papajorgji-Taylor D, Slaughter M, et al. Factors associated with opioid-tapering success: a mixed methods study. J Am Pharm Assoc 2021;61:248–57.e1.
- Frank JW, Levy C, Matlock DD, Calcaterra SL, Mueller SR, Koester S, Binswanger IA. Patients’ perspectives on tapering of chronic opioid therapy: a qualitative study. Pain Med 2016;17:1838–47.27207301
- Giannitrapani KF, Ahluwalia SC, McCaa M, Pisciotta M, Dobscha S, Lorenz KA. Barriers to using nonpharmacologic approaches and reducing opioid use in primary care. Pain Med 2018;19:1357–64.29059412
- Giannitrapani KF, Ahluwalia SC, Day RT, Pisciotta M, Dobscha S, Lorenz K. Challenges to teaming for pain in primary care. Healthc (Amst) 2018;6:23–7.28711504
- Henry SG, Paterniti DA, Feng B, Iosif AM, Kravitz RL, Weinberg G, et al. Patients’ experience with opioid tapering: a conceptual model with recommendations for clinicians. J Pain 2019;20:181–91.30243859
- Henry SG, Gosdin MM, White AEC, Kravitz RL. ‘It sometimes doesn’t even work’: patient opioid assessments as clues to therapeutic flexibility in primary care. J Gen Intern Med 2019;35:1635–40.31659669
- Henry SG, Bell RA, Fenton JJ, Kravitz RL. Goals of chronic pain management: do patients and primary care physicians agree and does it matter? Clin J Pain 2017;33:955–61.28244944
- Kennedy LC, Binswanger IA, Mueller SR, Levy C, Matlock DD, Calcaterra SL, et al. ‘Those conversations in my experience don’t go well’: a qualitative study of primary care provider experiences tapering long-term opioid medications. Pain Med 2018;19:2201–11.29126138
- Langford AV, Gnjidic D, Lin CWC, Bero L, Penm J, Blyth FM, et al. Challenges of opioid deprescribing and factors to be considered in the development of opioid deprescribing guidelines: a qualitative analysis. BMJ Qual Saf 2020;30:10881.
- Magee MR, Neilage AG, Avery N, Glare P, Ashton-James CE. McmHealth interventions to support prescription opioid tapering in patients with chronic pain: qualitative study of patients’ perspectives. JMIR Form Res 2021;5:e25969.34003133
- Matthias MS, Johnson NL, Shields C, Bair MJ, MacKie P, Huffman M, et al. ‘I’m not gonna pull the rug out from under you’: patient-provider communication about opioid tapering. J Pain 2017;18:1365–73.28690000
- McNeilage AG, Avery NS, Holliday S, Glare PA, Ashton-James CE. A qualitative trajectory analysis of patients’ experiences tapering opioids for chronic pain. Pain 2022;163:e246–60.33990111
- Quinlan J, Willson H, Grange K. Hopes and fears before opioid tapering: a quantitative and qualitative study of patients with chronic pain and long-term opioids. Br J Pain 2021;15:120–8.34055333
- White R, Hayes C, Boyes AW, Paul CL. Integrated primary healthcare opioid tapering interventions: a mixed-methods study of feasibility and acceptability in two general practices in New South Wales, Australia. Int J Integr Care 2020;20:6.
- Wu CA, Simon AJ, Modrich MA, Stacey MW, Matyas BT, Shubrook JH. Adapting the social-ecological framework for chronic pain management and successful opioid tapering. J Am Osteopath Assoc 2019;119:793–801.31790125
- Capano A, Weaver R, Burkman E. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgrad Med 2020;132:56–61.31711352
- Jackson HJ, Walters J, Raman R. Auricular acupuncture to facilitate outpatient opioid weaning: a randomized pilot study. Med Acupunct 2021;33:153–8.33912273
- Zheng Z, Guo RJ, Helme RD, Muir A, Da Costa C, Xue CCL. The effect of electroacupuncture on opioid-like medication consumption by chronic pain patients: a pilot randomized controlled clinical trial. Eur J Pain 2008;12:671–6.18035566
- Sullivan MD, Turner JA, DiLodovico C, D’Appollonio A, Stephens K, Chan YF. Prescription opioid taper support for outpatients with chronic pain: a randomized controlled trial. J Pain 2017;18:308–18.27908840
- ClinicalTrials.gov. Pilot Trial of Opioid Taper Support (POTS). 2013. URL: https://clinicaltrials.gov/show/NCT01883882 (accessed April 2023).
- Xue CC, Helme RD, Gibson S, Hogg M, Arnold C, Somogyi AA, et al. Effect of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: protocol of a randomised controlled trial. Trials 2012;13:169.22978476
- Zheng Z, Gibson S, Helme RD, Wang Y, Lu DSC, Arnold C, et al. Effects of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: a multicenter randomized controlled trial. Pain Med (Malden, Mass) 2019;20:397–410.
- Westanmo A, Marshall P, Jones E, Burns K, Krebs EE. Opioid dose reduction in a VA health care system: implementation of a primary care population-level initiative. Pain Med (Malden, Mass) 2015;16:1019–26.
- Michie S, Atkins L, West R. The Behaviour Change Wheel: A Guide to Designing Interventions. London: Silverback Publishing; 2014.
- Critical Appraisal Skills Programme. CASP Case Control Checklist. 2022. URL: https://casp-uk.net/casp-tools-checklists/ (accessed April 2023).
- Smith SM, Dworkin RH, Turk DC, Dermott MP, Eccleston C, Farrar JT, et al. McInterpretation of chronic pain clinical trial outcomes: IMMPACT recommended considerations. Pain 2020;161:2446–61.32520773
- Olsen MF, Bjerre E, Hansen MD, Tendal B, Hilden J, Hróbjartsson A. Minimum clinically important differences in chronic pain vary considerably by baseline pain and methodological factors: systematic review of empirical studies. J Clin Epidemiol 2018;101:87–106.e2.29793007
- Buonora M, Perez HR, Stumph J, Allen R, Nahvi S, Cunningham CO, et al. Medical record documentation about opioid tapering: examining benefit-to-harm framework and patient engagement. Pain Med 2020;21:2574–82.32142143
- Fortney JC, Burgess JF Jr, Bosworth HB, Booth BM, Kaboli PJ. A re-conceptualization of access for 21st century healthcare. J Gen Intern Med 2011;26:639–47.21989616
- Hatzenbuehler ML. Structural stigma: research evidence and implications for psychological science. Am Psychol 2016;71:742–51.27977256
- Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health 1999;89:1322–7.10474547
- Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011;6:42.21513547
- The Lancet. A time of crisis for the opioid epidemic in the USA. Lancet 2021;398:277.34303422
- Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain: United States, 2016. JAMA 2016;315:1624–45.26977696
- National Institute for Health and Care Excellence. Medicines Associated with Dependence or Withdrawal Symptoms: Safe Prescribing and Withdrawal Management for Adults. NG215. 2022. URL: www.nice.org.uk/guidance/ng215/resources/medicines-associated-with-dependence-or-withdrawal-symptoms-safe-prescribing-and-withdrawal-management-for-adults-pdf-66143776880581 (accessed April 2023).
- Crawley A, Murphy L, Regier L, McKee N. Tapering opioids using motivational interviewing. Can Fam Physician 2018;64:584–7.30108077
- Mardian A, Perez L, Pun T, Cheung M, Porter J, De Bruyne K, et al. Engagement in prescription opioid tapering research: the EMPOWER study and a coproduction model of success. J Gen Intern Med 2022;37:113–7.34389937
- Doherty AJ, Boland P, Reed J, Clegg AJ, Stephani AM, Williams NH, et al. Barriers and facilitators to deprescribing in primary care: a systematic review. BJGP Open 2020;4:bjgpopen20X101096.
- Waddell A, Lennox A, Spassova G, Bragge P. Barriers and facilitators to shared decision-making in hospitals from policy to practice: a systematic review. Implement Sci 2021;16:74.34332601
- Boland L, Graham ID, Légaré F, Lewis K, Jull J, Shephard A, et al. Barriers and facilitators of pediatric shared decision-making: a systematic review. Implement Sci 2019;14:7.30658670
- Rushforth B, McCrorie C, Glidewell L, Midgley E, Foy R. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review. Br J Gen Pract 2016;66:e114–27.26823263
- Sohal T, Sohal P, King-Shier KM, Khan NA. Barriers and facilitators for type-2 diabetes management in south Asians: a systematic review. PLOS ONE 2015;10:e0136202.26383535
- Lehne G, Bolte G. Impact of universal interventions on social inequalities in physical activity among older adults: an equity-focused systematic review. Int J Behav Nutr Phys Act 2017;14:20.28187766
- Birch JM, Jones RA, Mueller J, McDonald MD, Richards R, Kelly MP, et al. A systematic review of inequalities in the uptake of, adherence to, and effectiveness of behavioral weight management interventions in adults. Obes Rev 2022;23:e13438.35243743
- NIHR. Improving Inclusion of under-Served Groups in Clinical Research: Guidance from the NIHR-INCLUDE Project. London: NIHR; 2020.
- James J, Lai B, Witt T. Patient engagement survey regarding future double-blinded, randomized controlled trial of tapering of chronic opioid therapy. J Prim Care Community Health 2019;10:9890231.
- Bach-Mortensen AM, Lange BCL, Montgomery P. Barriers and facilitators to implementing evidence-based interventions among third sector organisations: a systematic review. Implement Sci 2018;13:103.30060744
Interventions to safely and effectively reduce (taper) use of opioids in chronic non-cancer pain: a systematic review · References
References
Attribution. Ruaraidh Hill; Michelle Maden; Rui Duarte; Sam Eldabe; Su Golder; Marty Chaplin et al. (2026). Interventions to safely and effectively reduce (taper) use of opioids in chronic non-cancer pain: a systematic review. National Institute for Health and Care Research. Copyright © 2026 Hill et al. Licensed under CC BY 4.0. NCBI Bookshelf NBK621520. CC BY 4.0. Original source ↗. Text reproduced from the Bookshelf XML without changing wording; figures, images and supplements are not reproduced.