title: Preferences of caregivers and patients regarding opioid analgesic use in terminal care.
abstract: BACKGROUND
  Patients and caregivers participate in decision-taking, and their views should be considered in the preparation of Clinical Practice Guidelines (CPGs). We involved them in the development of a CPG on the safe use of major opioids.
  
  
  OBJECTIVE
  To identify the values and preferences of patients and caregivers on the use of opioids and the desired outcomes, to investigate motives for the acceptance/rejection of opioid therapy, and to evaluate their beliefs and information about these drugs.
  
  
  METHODS
  A qualitative study was conducted using semi-structured interviews in an Andalusian population of terminal patients and caregivers (N = 42). Study variables included the role, diagnosis, and adherence to treatment. Content and validity analyses were performed.
  
  
  RESULTS
  Less than one-third of participants recognized the term opioid. Among these, false beliefs were held related to the addictive nature of these drugs, their exclusive use in terminal cases and at the end of life, and their association with premature death. The information received was very general: it was known that they are "useful for pain," and some were informed about the administration route, composition, and habituation. Participation in decision making was usually limited to reporting symptoms to the physician.
  
  
  CONCLUSIONS
  These patients and caregivers demonstrated a preference for pain alleviation by opioid treatment and gave negative assessments on adverse digestive effects that can cause this treatment to be abandoned. They expressed interest in receiving more information and in participating in therapeutic decision making, and they reported erroneous beliefs and a lack of information about the effects of these drugs.
authors: Andalusian School of Public Health, Granada, Spain.
authors: Noelia
authors: N
authors: García-Toyos
authors: María J
authors: MJ
authors: Escudero-Carretero
authors: Reyes
authors: R
authors: Sanz-Amores
authors: Juan-Antonio
authors: JA
authors: Guerra-De Hoyos
authors: Juan-Manuel
authors: JM
authors: Melchor-Rodríguez
authors: María-Isabel
authors: MI
authors: Tamayo-Velázquez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D017028:Caregivers / Q000523:psychology*; D003258:Consumer Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000523:psychology*; D057240:Patient Preference; D017410:Practice Guidelines as Topic; D036301:Qualitative Research; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Caregiver; Opioids; Pain Management; Palliative Treatment