Table 3 Specific Barriers and Facilitators to Opioid Prescribing in Older Adults
Themes | Participants mentioning (N = 26) n (%) | Newly identified theme* |
|---|---|---|
Provider-level barriers | Â | Â |
   Fear of causing harm from adverse effects | 20 (77) | No4,6,7,12 |
   Subjectivity of pain | 16 (62) | No11,24 |
   Lack of education in pain management | 9 (35) | No5,9,12-14 |
   Problem converting or dosing opioids | 8 (31) | No5 |
   Concern for abuse, addiction or dependence | 5 (19) | No4-12 |
   Concern for legal/regulatory sanction | 3 (12) | No5-7,9,10 |
   Concern for family member/caregiver abuse | 3 (12) | Yes |
Patient/family-level barriers | Â | Â |
   Older patients reluctant to take opioid | 18 (69) | Yes |
   Stigma | 15 (58) | No6 |
   Family reluctant to have older patient take opioid | 10 (38) | Yes |
   Financial (medication costs) | 6 (23) | No6 |
Facilitators | Â | Â |
   Patient and family education about opioids | 14 (54) | Yes |
   Studies demonstrating long-term benefit and validated risk assessment tools | 11 (42) | No12 |
   Easy access to peer or specialist support | 7 (27) | Yes |
   Evidence-based tools to help calculate starting dose | 3 (12) | Yes |