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Author: search.filters.author.Devan HHas files: Yes

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    “The Fact [Is] That There Is No Easy Way”. A Qualitative Study of the Experiences of Aotearoa New Zealand Clinicians with Opioid Tapering for Chronic Non-Cancer Pain
    (Dove Medical Press Limited, 2025-11-18) Fu R; Bean D; Te Morenga L; Frei D; Devan H; Atkinson T
    Objective: Opioid tapering is a complex process for both clinicians and patients with chronic pain. This qualitative study explored the experiences of Aotearoa New Zealand clinicians in managing opioids for patients with chronic non-cancer pain. Methods: Purposive and snowball sampling were used to interview nineteen health professionals including general practitioners (n=5), pain medicine specialists (n=5), addiction medicine specialists (n=4), pain fellows (n=3), addiction medicine registrar (n=1) and a pain nurse practitioner (n=1). Data were collected using a face-to-face focus group and fourteen individual interviews conducted via Zoom. The data were analysed using a Reflexive Thematic Analysis approach. Independent parallel coding was done by members of our research team, and the final themes were iteratively developed by mutual consensus. Results: This qualitative study suggests that meaningful opioid tapering requires a patient-centred approach that considers the individual’s unique sociopsychobiomedical context. Clinicians emphasised the importance of building trust, addressing fears, and tailoring tapering regimens to patients’ needs and motivations. While opioid tapering is a complex process for all patients, participants acknowledged unique considerations for supporting people living in rural areas – Māori and Pasifika and their whānau (families and significant others) addressing social determinants of health. There were overwhelming accounts of clinician distress from all participants especially for rural general practitioners due to the lack of support, conflicting practices, limited resourcing, and time constraints. Conclusion: These findings call for a co-ordinated, multidisciplinary approach to opioid tapering that addresses systemic inequities and prioritises patient and clinician well-being.
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    ‘Let us enjoy the fruits of our own labour, we have our own solutions’ Creative co-design methods and narratives of Māori whānau with chronic pain
    (Taylor and Francis Group on behalf of the Royal Society of New Zealand, 2025-07-07) Davies C; Devan H; Kokiri Whānau; Te Morenga L
    Chronic or persistent pain disproportionately affects Māori and their whānau (family and significant others). Our previous engagement with Māori living with persistent pain has identified significant barriers for Māori to accessing primary, secondary, and tertiary services. This paper describes the insights obtained from Māori living with persistent pain by using a creative art-based data collection method as part of a co-design process to understand how they would like to be supported in their pain management journey. We used brainstorming discussion sessions and a creative art session to encourage divergent thinking and to stimulate innovative ideas for better pain management support for Māori. The creations showed a deep connection to taiao (nature) and the support of whānau as sources of strength. Connecting with other whānau living with pain in a safe space (i.e. community setting or a marae (community meeting place)) was an aspiration. Existing mainstream services were viewed as deficit-focused with an overwhelming support for Māori-led solutions delivered kanohi-ki-te-kanohi (face-to-face). Creative activities can be used as a culturally appropriate research method for both generating rich insights into the lived experiences of Māori living with persistent pain and how to deliver culturally responsive pain services.