Identification of barriers to safe opioid prescribing in primary care: a qualitative analysis of field notes collected through academic detailing

Understanding barriers to safe opioid prescribing in primary care is critical amid the epidemic of prescription opioid abuse, misuse, and overdose in the US. Educational outreach strategies, such as academic detailing (AD), provide a forum for identification of barriers to, and strategies to facilit...

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Bibliographic Details
Published in:British journal of general practice 2020-08, Vol.70 (697), p.e589-e597
Main Authors: Saffore, Christopher D, Tilton, Sarette T, Crawford, Stephanie Y, Fischer, Michael A, Lee, Todd A, Pickard, A Simon, Sharp, Lisa K
Format: Article
Language:English
Subjects:
Drug abuse
Epidemics
Family physicians
Narcotics
Pain management
Patient safety
Prescriptions
Primary care
Qualitative research
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Summary:Understanding barriers to safe opioid prescribing in primary care is critical amid the epidemic of prescription opioid abuse, misuse, and overdose in the US. Educational outreach strategies, such as academic detailing (AD), provide a forum for identification of barriers to, and strategies to facilitate, safe opioid prescribing in primary care. To identify barriers to safe opioid prescribing among primary care providers (PCPs) through AD. Qualitative analysis of data was collected through an existing AD intervention to improve safe opioid prescribing in primary care. The AD intervention was delivered from June 2018 to August 2018 to licensed PCPs with prescriptive authority within a large independent health system in the metropolitan Chicagoland area. The AD intervention involved visits by trained detailers to PCPs who contemporaneously documented details from each visit via field notes. Using qualitative analysis, field notes were analysed to identify recurring themes related to opioid prescribing barriers. Detailer-entered field notes from 186 AD visits with PCPs were analysed. Barriers to safe opioid prescribing were organised into six themes: 1) gaps in knowledge; 2) lack of prescription monitoring programme (PMP) utilisation; 3) patient pressures to prescribe opioids; 4) insurance coverage policies; 5) provider beliefs; and 6) health system pain management practices. Barriers to safe opioid prescribing in primary care, identified through AD visits among this large group of PCPs, support the need for continued efforts to enhance pain-management education, maximise PMP utilisation, and increase access to, and affordability of, non-opioid treatments.
ISSN:0960-1643
1478-5242
DOI:10.3399/bjgp20X711737