Exploring community pharmacists’ role in managing patients prescribed opioid medications for chronic non-cancer pain

Abstract Introduction There has been an increasing concern regarding the opioid crisis, marked by a significant rise in prescriptions and related adverse outcomes, including addiction, overdoses, and fatalities.1 This crisis has emphasised the need for better ways to manage pain, especially chronic non-cancer pain. Pharmacists, being accessible frontline healthcare providers, actively engage in addressing these challenges, working to improve patient care while mitigating the risks associated with opioid use.2 Aim This study explored the role of community pharmacists in managing patients prescribed opioid medications for chronic non-cancer pain. Methods A qualitative interview-based study was conducted with community pharmacists in England between October and December 2023. Pharmacists who worked in community pharmacies in England, managed patients prescribed opioid medications for chronic pain, and had access to Microsoft Teams®, were eligible. They were approached via email and social media channels using convenience sampling, with an intended sample size of 8–10 participants based on guidance for qualitative studies. Interviews were conducted online using a semi-structured interview guide, which was piloted in a mock interview. It explored their experiences, confidence, and satisfaction in managing patients prescribed opioids for chronic non-cancer pain. Interviews were audio-recorded and transcribed by Teams®. Transcripts were cleaned, anonymised, and analysed using Braun and Clarke’s reflexive thematic analysis framework. Two researchers coded the transcripts independently and triangulated their findings; the themes were rechecked by a third researcher. Reporting adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results Seven pharmacists (four male, three female) participated, with most (N = 4) having over 20 years of professional experience. Four participants were based in large urban towns. Four major themes were identified. 1) Roles and responsibilities—pharmacists extended their roles beyond dispensing to include patient education, medicine optimisation, and collaboration with healthcare teams. 2) Satisfaction and confidence—pharmacists valued their role and were satisfied with their service. 3) Challenges and Barriers—limited patient understanding, communication gaps, lack of access to records, and time constraints hindered effective opioid management. These also affected their confidence and satisfaction. 4) Views and recommendations—pharmacists highlighted the need for specialised training, mentorship, greater collaboration, and expanded roles, including prescribing rights. Conclusion This study highlights how community pharmacists contribute to the management of patients prescribed opioid medications by offering education, medicines optimisation support, and collaborative input where possible. However, challenges include need for additional training and continuous education. A key strength of this research is the in-depth exploration of pharmacists’ real-world experiences. However, limitations include a small sample size and unachieved data saturation reducing the transferability of findings. Further research involving a larger and diverse sample is needed to explore pharmacists’ roles across community, GP practice, and hospital settings.