• Paul Perkins, Anne Parkinson, Rob Hebdon, and Ralph K Akyea.
• Gloucestershire Hospitals NHS Foundation Trust (P.P.), Cheltenham, UK; Sue Ryder Leckhampton Court Hospice (P.P., A.P.), Cheltenham, UK. Electronic address: paul.perkins@suerydercare.org.
• J Pain Symptom Manage. 2022 Jun 1; 63 (6): e691-e697.

ContextSome patients take their strong opioid painkillers as unmeasured sips.ObjectivesTo investigate how and why patients take their medication in this way.MethodsPatient receiving specialist palliative care who take their strong opioid painkillers as unmeasured sips were recruited. Measurement was made of the mass of two sips per patient and qualitative interviews using a topic guide were conducted. Interview transcripts were thematically analyzed using a phenomenological approach.ResultsOnly two of 16 patients were taking within 20% of the correct dose of their breakthrough liquid strong analgesia. Many varied the dose depending on the severity of the pain episode. Convenience, confusion about the correct dose, and issues with spoons were the other main reasons for people choosing to sip.ConclusionThis is the first published study exploring the behavior of patients who take their strong analgesia as unmeasured sips. Knowing that patients who sip are likely to be taking an incorrect dose, and the reasons behind sipping may help clinicians to help these patients to manage their pain better.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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