ArticleBMC family practice2015
Understanding long-term opioid prescribing for non-cancer pain in primary care: a qualitative study.
Article in BMC family practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Experiences of people taking opioid medication for chronic non-malignant pain: a qualitative evidence synthesis using meta-ethnography.BMJ open · 2020Pooled it
- Effects and costs of a group-based educational intervention to reduce opioid use in people with chronic pain: I-WOTCH RCT.Health technology assessment (Winchester, England) · 2026Trial
- Exploration of the barriers, enablers and experiences of opioid management for chronic non-cancer pain (CNCP) in the general practice setting within the United Kingdom: A meta-synthesis.British journal of pain · 2025Article
- Realities of opioid and gabapentinoid deprescribing in socioeconomically disadvantaged communities: a qualitative evaluation.BJGP open · 2025Article
- Resentful, Resigned and Respectful: Opioid Analgesics, Pain and Control, a Qualitative Study.Pharmacy (Basel, Switzerland) · 2025Article
- Prescription of Strong Opioids in Chronic Non-Cancer Pain in the Province of Valladolid (Spain).Life (Basel, Switzerland) · 2025Article
- Article
- Exploring Pain Clinical Specialists' Perspectives on Opioid Optimization for Chronic Non-Malignant Pain in England.Journal of pain research · 2025Article
- Diagnosing and managing prescription opioid use disorder in patients prescribed opioids for chronic pain in Australian general practice settings: a qualitative study using the theory of Planned Behaviour.BMC primary care · 2024Article
- Patients' perspectives about the role of primary healthcare providers in long-term opioid therapy: a qualitative study in Dutch primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Home care for patients with opioid use disorders: A qualitative study of registered nurses' experiences of pain management.Nursing open · 2024Article
- Understanding general practitioners' prescribing choices to patients with chronic low back pain: a discrete choice experiment.International journal of clinical pharmacy · 2024Article
- Private prescribing of controlled opioids in England, 2014-2021: a retrospective observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Observational
- Article
- Long-term, high-dose opioid prescription for chronic non-cancer pain in primary care: an observational study.BJGP open · 2022Article
- A qualitative interview study of GPs' experiences of prescribing opioid medication for chronic pain.BJGP open · 2022Article
- Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015.British journal of pain · 2022Article
- Collaboration between adult patients and practitioners when making decisions about prescribing opioid medicines for chronic non-cancer pain in primary care: a scoping review.British journal of pain · 2022Article
- Patient Perspectives on the Appropriate Use of Prescribed Opioids in Chronic Non-Malignant Pain: Analysis of Online Forums Using Theoretical Domains Framework.Journal of pain research · 2022Article
- Perspectives of pain specialists, patients, and family members on long-term opioid use for chronic non-cancer pain: a qualitative study.BMC anesthesiology · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe place of opioids in the management of chronic, non-cancer pain is limited. Even so their use is escalating, leading to concerns that patients are prescribed strong opioids inappropriately and alternatives to medication are under-used. We aimed to understand the processes which bring about and perpetuate long-term prescribing of opioids for chronic, non-cancer pain.
methodsWe held semi-structured interviews with patients and focus groups with general practitioners (GPs). Participants included 23 patients currently prescribed long-term opioids and 15 GPs from Leeds and Bradford, United Kingdom (UK). We used a grounded approach to the analysis of transcripts.
resultsPatients are driven by the needs for pain relief, explanation, and improvement or maintenance of quality of life. GPs' responses are shaped by how UK general practice is organised, available therapeutic choices and their expertise in managing chronic pain, especially when facing diagnostic uncertainty or when their own approach is at odds with the patient's wishes. Four features of the resulting transaction between patients and doctors influence prescribing: lack of clarity of strategy, including the risk of any plans being subverted by urgent demands; lack of certainty about locus of control in decision-making, especially in relation to prescribing; continuity in the doctor-patient relationship; and mutuality and trust.
conclusionsProblematic prescribing occurs when patients experience repeated consultations that do not meet their needs and GPs feel unable to negotiate alternative approaches to treatment. Therapeutic short-termism is perpetuated by inconsistent clinical encounters and the absence of mutually-agreed formulations of underlying problems and plans of action. Apart from commissioning improved access to appropriate specialist services, general practices should also consider how they manage problematic opioid prescribing and be prepared to set boundaries with patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.