Design of a Patient Education Leaflet for Preventing Inappropriate Opioid Analgesics Use in Swiss Community Pharmacies

Objective: Pain affects up to 30% of the population, and opioids are common analgesic treatments. These carry risks of misuse, but many pharmacists lack access to structured information resources that would enable systematic and structured communication with patients. Therefore, our study aimed to establish the content validity of a patient education leaflet for opioid analgesic users to promote safe use and prevent misuse.

Methods: A draft leaflet was developed, and its key messages were assessed through semi-structured interviews with 6 patients, recruited via professional social networks and patient associations. The leaflet was further reviewed during focus groups involving two groups of community pharmacists (CPs; n=5; n=7), and four general practitioners (GPs). Additionally, medical experts in analgesia and addiction medicine, and a patient representative, provided content input. A thematic analysis was conducted using the Framework Approach. Finally, local health authorities scrutinized the leaflet before endorsing it.

Results: Four patients out of six needed more opioid information. In focus-groups, three CPs suggested less directive incentives in the leaflet, while all GPs emphasized opioids’ benefits for severe pain and cautioned against over-alarming messages. CPs and GPs converged on the need for two different leaflets: for initiation and experienced use. Experts provided additional patient information as adjunct material to the leaflet and stressed explaining to patients the reasoning behind each recommendation. A patient representative asked to avoid giving lengthy explanations. Local health authorities requested a German translation and gender-inclusive language. The final leaflets emphasize adherence to prescribed use, safety recommendations, actions if warning signs appear, and include further information via QR code.

Conclusions: Involving patients, CPs, GPs, medical experts, a patient representative, and local health authorities led to two targeted patient education leaflets. Participants contributed to its content, non-alarming phrasing, and adjunct material. Differing viewpoints were reconciled when adapting the final version of the leaflet.

Practice implications: This study highlights the importance of involving different concerned stakeholders in designing relevant written material for patients to support their future use in practice.