Background In the UK, we are seeing an increase in the number of older drug users including those accessing drug treatment services. Because harm reduction interventions have resulted in more older drug users dying of non-drug related causes, studies suggest that they are likely to have a higher morbidity than the general population. Serving the palliative needs of those with substance use disorder (SUD) is often difficult due to the complexities of symptoms, their social circumstances and health care practitioner (HCP) understanding. A rapid evidence assessment in 2019 revealed limited inquiry into the experiences and attitudes of service providers.
Aim To evaluate the knowledge, concerns and attitudes of palliative HCP’s (doctors, nurses and healthcare assistants) working in a range of clinical environments in treating patients with SUD in the Mid-Essex region.
Methods A mixed methods approach was carried out using an online survey tool. Quantitative evaluation of knowledge was measured using a 10-item true/false questionnaire. Confidence in managing patients with SUD was investigated using a Likert scale. Concerns relating to management were collated with a qualitative approach and interpreted by emergent coding analysis.
Results 40 health care practitioners (HCPs) working in the community, hospice inpatient unit or hospital completed the survey. 82% had experience in managing patients with SUD. Knowledge about medicine management and pain control was varied across the three roles. Although the majority felt confident in assessing pain in SUD, over 70% lacked confidence in managing opioid substitution therapies. Confidence in planning discharge was also low. Frequently expressed concerns included tolerance to analgesia, unpredictable behaviour and safe drug storage.
Conclusions Despite the increasing palliative needs in SUD, there appear to be gaps in knowledge and low confidence towards management amongst HCP’s. More support through education and policy is required at a local level.
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