• Elsemiek A W Jansen-Groot Koerkamp, Loes de Kleijn, Romina Fakhry, Alessandro Chiarotto, Mette Heringa, Hanneke J B M Rijkels-Otters, Jeanet W Blom, Mattijs E Numans, Bart W Koes, and Marcel L Bouvy.
• SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands.
• Fam Pract. 2023 Dec 22; 40 (5-6): 827843827-843.

BackgroundOver the past decades, opioid prescriptions have increased in the Netherlands. The Dutch general practitioners' guideline on pain was recently updated and now aims to reduce opioid prescriptions and high-risk opioid use for non-cancer pain. The guideline, however, lacks practical measures for implementation.ObjectiveThis study aims to determine practical components for a tool that should assist Dutch primary care prescribers and implements the recently updated guideline to reduce opioid prescriptions and high-risk use.MethodsA modified Delphi approach was used. The practical components for the tool were identified based on systematic reviews, qualitative studies, and Dutch primary care guidelines. Suggested components were divided into Part A, containing components designed to reduce opioid initiation and stimulate short-term use, and Part B, containing components designed to reduce opioid use among patients on long-term opioid treatment. During three rounds, a multidisciplinary panel of 21 experts assessed the content, usability, and feasibility of these components by adding, deleting, and adapting components until consensus was reached on the outlines of an opioid reduction tool.ResultsThe resulting Part A consisted of six components, namely education, opioid decision tree, risk assessment, agreements on dosage and duration of use, guidance and follow-up, and interdisciplinary collaboration. The resulting Part B consisted of five components, namely education, patient identification, risk assessment, motivation, and tapering.ConclusionsIn this pragmatic Delphi study, components for an opioid reduction tool for Dutch primary care-givers are identified. These components need further development, and the final tool should be tested in an implementation study.© The Author(s) 2023. Published by Oxford University Press.

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