Table 1.

Feedback from PPI informing intervention development

Discussion topic	Feedback informing intervention development
Behaviour change	Agreed aims should be a reduction in opioid consumption and engagement in the I-WOTCH programme. Behaviour change needs to be accepted before opioid reduction can occur.
Understanding motivation to change behaviour	Changing medication and reducing medication can be motivated by: (i) a trade-off to fill the deficit of the effect of the drug (something else needed that is as effective as the drug they would lose) (ii) reduction in side effects Use of case studies of people who had successfully stopped taking opioids would be useful.
Content and topics to be covered	The intervention would benefit from being informative (opioid education, especially long-term consequences, pros and cons of opioid use and managing withdrawal). The following topics were recommended for inclusion: What is pain Acceptance—pain and learning to live better with pain Impact of pain – and integrate this information with taking medication (Opioids), why and how? The importance of hobbies and having a distraction to manage the pain Offer alternative non-pharmacological ways of coping, for example, mindfulness and relaxation Incorporate movement Guidance on posture and exercise/activity Pacing—not over doing things
Dependency versus addiction	It was felt important to distinguish between dependency and addiction, as some were concerned about the stigma and labels attached to long-term opioid use for chronic pain.
Delivery of I-WOTCH Intervention, who?	Feedback favoured the course to be delivered jointly by a HCP and a lay facilitator (someone who had experience of long-term pain and opioid use/tapering).
Structure of intervention	Group and individual care approaches were valued. Length of the proposed programme (3-day group sessions and ongoing one to one support) was supported. The duration of intervention was not viewed as burdensome given that some had people who had experienced severe withdrawal symptoms, and therefore ongoing support over the 8–10 weeks was needed. There was a consensus that a group-based format and group cohesion would be optimal because of the potential for social comparison, social validation and development of social support. Volunteers identified the impact of opioid use on enhanced day-to-day activities as important evaluation outcomes, including: work productivity, looking after children, and overall functioning.
Communication during study	Volunteers welcomed the idea of having a study website to give participants an opportunity to be updated about the study as a whole and progress.

HCP, healthcare professional; I-WOTCH, Improving the Wellbeing of people with Opioid Treated CHronic pain.