Manuscript Review JAN-2024-3573 entitled “Nurse practitioner conceptions of capability providing medication and safe supply for opioid use disorder in primary care: A phenomenographic study"

Thank you for the opportunity to review the manuscript with the title “Nurse practitioner conceptions of capability providing medication and safe supply for opioid use disorder in primary care: A phenomenographic study". Overall, I enjoyed the brief introduction, the sound methodology, the well-structured presentation of the results. Nonetheless, certain aspects of this work could be improved, such as the introduction and discussion of results.

Introduction
1. Your introduction does not include challenges in caring in the landscape of trauma and loss. Managing emotions during/after caring individuals with addiction problems exposed to trauma and suffering can leave nurses feeling emotionally drained while absorbing unmanageable emotions (10.1097/JTN.0000000000000274, 10.5281/zenodo.56816). Reference to the dangers of absorbing trauma and the alarming rates of secondary traumatic stress in addiction nurses (10.1097/JAN.0000000000000434) will enhance the comprehensiveness of your introduction.
2. Overdose deaths from prescription drugs have exceeded those from street drugs. Please discuss in your introduction.
3. Prescription drug diversion is a practice whereby an individual redirects their prescribed drugs to another party for illicit use. Please discuss in your introduction.
4. There is not even one sentence on family members and significant others in both introduction and discussion as if they are invisible in the primary care of the specific population (e.g. 10.1080/09687637.2017.1399105, 10.1007/978-3-030-78771-4_41)

Method
Please include a sub-section on reflexivity

Results
Table 1 Training in addition Please correct

Did participants referred to moral distress and ethical challenges during their career?.

One of the barriers to safe opioid prescribing in the literature is providers’ experiences with personal tragedy due to the opioid epidemic, such as the loss of a family member from an opioid overdose. Did any of your participants discussed personal tragedies? You could alternatively refer to personal tragedies in discussion e.g. 10.1097/JAN.0000000000000434)

Discussion
1. It is striking that recently qualified primary care nurses in your sample do not have any education on addiction. Please refer to the cultural context to balance the reference to universal truths and discuss in the context of international evidence.
2. Discuss your results in the context of ethical challenges experienced by other primary care providers.

Clinical Implications
3. Ongoing professional training on trauma dynamics, self-care and clinical supervision may protect primary care providers from frustration and compassion fatigue during safe opioid prescribing.

Thank you! All the best!

Manuscript Review JAN-2024-3573-R entitled “Nurse practitioner conceptions of capability providing medication and safe supply for opioid use disorder in primary care: A phenomenographic study"

I would like to thank you for the opportunity to review the manuscript with the title “Nurse practitioner conceptions of capability providing medication and safe supply for opioid use disorder in primary care: A phenomenographic study". Overall, I consider the article ready for publication

All the best!