Background

Sciatica is often a painful and disabling condition, with medication routinely the first line of management. It is important to describe patients experiences of taking medication for sciatica, the reasons for commencing and reasons for cessation, the effects of the medication in symptom management and any other potential positive or deleterious effects.

Objectives

To describe patient experiences of medication for the relief of symptoms of sciatica.

Study design

Qualitative analysis of data from a mixed-methods randomised controlled pilot study.

Methods

A total of 46 semi-structured interviews were conducted with 33 consenting participants (19 female) recruited from 14 GP practices. A purposive sampling strategy ensured a range of age, severity of pain and disability. Interviews were recorded and transcribed verbatim prior to thematic analysis, which aimed to identify the important, interesting or divergent views within the data.

Findings

Participant experiences of pain were often severe with significant disability and fear. The use of a combination of medications was common, including the use of opioids and other medication inconsistent with national (NICE) guidance. Most participants found medication ineffective and reported significant side-effects, often necessitating cessation of the drugs or the use of alternatives. Despite the regularity of participants stopping all medication for sciatica, their pain levels still significantly eased over the 6-month period of the study.

Conclusions

The study highlighted a lack of perceived effectiveness for prescribed medication, often with concomitant side-effects. Clinicians should be cognisant of the fears that patients hold in terms of the cause and severity of sciatica, as well as fears of prescribed medication.

中文翻译：

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坐骨神经痛患者用药体验的定性探索

背景

坐骨神经痛通常是一种痛苦和致残的疾病，药物治疗通常是第一线治疗。重要的是要描述患者服药治疗坐骨神经痛的经历、开始和停止的原因、药物对症状管理的影响以及任何其他潜在的积极或有害影响。

目标

描述患者使用药物缓解坐骨神经痛症状的体验。

学习规划

混合方法随机对照试验研究数据的定性分析。

方法

共进行了 46 次半结构化访谈，从 14 家全科医生诊所招募了 33 名同意的参与者（19 名女性）。有目的的抽样策略确保了年龄、疼痛的严重程度和残疾的范围。在主题分析之前，访谈被逐字记录和转录，目的是确定数据中重要的、有趣的或不同的观点。

发现

参与者的疼痛经历往往很严重，伴有明显的残疾和恐惧。药物组合的使用很常见，包括使用阿片类药物和其他不符合国家 (NICE) 指南的药物。大多数参与者发现药物无效并报告了严重的副作用，通常需要停止使用药物或使用替代品。尽管参与者经常停止所有治疗坐骨神经痛的药物，但在 6 个月的研究期间，他们的疼痛水平仍然显着缓解。

结论

该研究强调了处方药缺乏感知效果，通常伴随着副作用。临床医生应该意识到患者对坐骨神经痛的原因和严重程度的恐惧，以及对处方药的恐惧。