ArticleBritish journal of pain2019
'If you can't see a dilemma in this situation you should probably regard it as a warning': a metasynthesis and theoretical modelling of general practitioners' opioid prescription experiences in primary care.
Article in British journal of pain, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- General practitioners' attitudes towards opioids for non-cancer pain: a qualitative systematic review.BMJ open · 2022Pooled it
- Challenges in pain management and opioid prescribing practices following traumatic injury: a focus group study with orthopedic surgeons and general practitioners.Scandinavian journal of primary health care · 2025Article
- A qualitative interview study exploring the experiences of pain specialists on prescribing opioids for chronic non-cancer pain.Scientific reports · 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
- Opioid Treatment in Primary Care: Knowledge and Practical Use of Opioid Therapy.Healthcare (Basel, Switzerland) · 2024Article
- A pharmacist-led intervention to improve the management of opioids in a general practice: a qualitative evaluation of participant interviews.International journal of clinical pharmacy · 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
- Opioids, opioids and more opioids.British journal of pain · 2019Article
- Changing or validating physician opioid prescribing behaviors through audit and feedback and academic detailing interventions in primary care.Implementation research and practiceArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe prescribing of opioids has increased internationally in developed countries in recent decades within primary and secondary care. The majority of patients with chronic non-malignant pain (CNMP) are managed by their general practitioner (GP). Recent qualitative studies have examined the issue of opioid prescribing for CNMP from a GP viewpoint. The aim of this study is to identify and synthesise the qualitative literature describing the factors influencing the nature and extent of opioid prescribing by GPs for patients with CNMP in primary care.
methodsMEDLINE, Embase, PsycINFO, Cochrane Database, International Pharmaceutical Abstracts, Database of Abstracts of Reviews of Effects, CINAHL and Web of Science were systematically searched from January 1986 to February 2018. The full text of included articles was reviewed using the Critical Appraisal Skills Programme (CASP) tool for qualitative research. The papers were coded by two researchers and themes organised using Thematic Network Analysis. Themes were constructed in a hierarchical manner, basic themes informed organising themes which informed global themes. A theoretical model was derived using global themes to explain the interplay between factors influencing opioid prescribing decisions.
resultsFrom 7020 records, 21 full text papers were assessed, and 13 studies included in the synthesis; 9 were from the United States, 3 from the United Kingdom and 1 from Canada. Four global themes emerged: suspicion, risk, agreement and encompassing systems level factors. These global themes are inter-related and capture the complex decision-making processes underlying opioid prescribing whereby the physician both consciously and unconsciously quantifies the risk-benefit relationship associated with initiating or continuing an opioid prescription.
conclusionRecognising the inherent complexity of opioid prescribing and the limitations of healthcare systems is crucial to developing opioid stewardship strategies to combat the rise in opioid prescription morbidity and mortality.
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