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Carer preferences of route of administration of transmucosal diamorphine and willingness to take part in a randomised controlled trial: an interview study (DIPPER).

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cam.issuedOnline2022-05-17
dc.contributor.authorJamieson, Liz
dc.contributor.authorHarrop, Emily
dc.contributor.authorLiossi, Christina
dc.contributor.authorBoyce, Katherine
dc.contributor.authorMitchell, Lorraine
dc.contributor.authorJohnson, Margaret
dc.contributor.authorJani, Yogini
dc.contributor.authorAkinyooye, Victoria
dc.contributor.authorSkene, Simon S
dc.contributor.authorWong, Ian CK
dc.contributor.authorHoward, Richard F
dc.contributor.authorOulton, Kate
dc.contributor.orcidJamieson, Liz [0000-0002-3667-0423]
dc.contributor.orcidHarrop, Emily [0000-0002-2480-2062]
dc.contributor.orcidLiossi, Christina [0000-0003-0627-6377]
dc.contributor.orcidJani, Yogini [0000-0001-5927-5429]
dc.contributor.orcidSkene, Simon S [0000-0002-7828-3122]
dc.contributor.orcidWong, Ian CK [0000-0001-8242-0014]
dc.contributor.orcidHoward, Richard F [0000-0001-9271-0074]
dc.contributor.orcidOulton, Kate [0000-0002-5778-3849]
dc.date.accessioned2022-06-29T19:42:13Z
dc.date.available2022-06-29T19:42:13Z
dc.date.issued2022-05-17
dc.date.updated2022-06-29T19:42:13Z
dc.description.abstractBACKGROUND: Children and young people are usually given liquid morphine by mouth for breakthrough pain, which can take thirty minutes to work. A faster-acting, quickly absorbed, needle-free pain medicine, that is easy to administer is needed such as transmucosal (sublingual, buccal, intranasal) diamorphine. Research evidence relating to the administration of medication for breakthrough pain in children and young people is limited. This study aims to describe the experiences and preferences of parents and/or children and young people regarding the route of administration of diamorphine, barriers and facilitators comparative to oral morphine, and participation in a randomised controlled trial. METHODS: In-depth, semi-structured interviews with parents and/or children and young people at home or hospital/hospice. RESULTS: Thirteen interviews with: nine mothers, one father, and three sets of parents jointly. No interviews took place with a child/young person. Most families had experience of the buccal route which was effective in ease of administration and time to control pain. The intranasal route was preferred by parents irrespective of experience. Parents' willingness for their child to take part in a trial depended on the time commitment, their child's pain trajectory and the stability of analgesic requirements. CONCLUSION: A randomised controlled trial of oral morphine versus transmucosal diamorphine would need to consider trial logistics, especially time commitment. Parents felt that the trial should be introduced initially by the clinical team, with written information from the research team, and sufficient time to ask questions. Patients who had discontinued oral morphine because of side effects, or those with gastrointestinal failure, should be excluded. Maintaining stability in pain management was essential to families, so the timing of the trial is a potential issue.
dc.identifier.doi10.17863/CAM.85844
dc.identifier.eissn1472-684X
dc.identifier.issn1472-684X
dc.identifier.other35581660
dc.identifier.otherPMC9110942
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/338431
dc.languageeng
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1186/s12904-022-00951-2
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceessn: 1472-684X
dc.sourcenlmid: 101088685
dc.subjectBreakthrough pain
dc.subjectDiamorphine
dc.subjectOpioids
dc.subjectPaediatrics
dc.subjectPain management
dc.subjectPalliative care
dc.subjectTerminal care
dc.subjectAdolescent
dc.subjectAnalgesics, Opioid
dc.subjectBreakthrough Pain
dc.subjectCaregivers
dc.subjectChild
dc.subjectHeroin
dc.subjectHumans
dc.subjectMorphine
dc.subjectQualitative Research
dc.titleCarer preferences of route of administration of transmucosal diamorphine and willingness to take part in a randomised controlled trial: an interview study (DIPPER).
dc.typeArticle
dcterms.dateAccepted2022-03-28
prism.issueIdentifier1
prism.publicationNameBMC Palliat Care
prism.volume21
pubs.funder-project-idResearch for Patient Benefit Programme (PB-PG-0317-20036)
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1186/s12904-022-00951-2

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