HOPE-AO overprescribing in older adults with chronic pain: a protocol for qualitative interviews with patients and healthcare professionals.

Background: Pain in the older population is often poorly identified and subsequently poorly managed. Many myths and misconceptions exist amongst both older adults and healthcare professionals, including fear of using other methods of pain management and failure to monitor the impact of current approaches. This leads to underreporting of pain by the older adult population, overprescribing of pain medication, and failure to monitor the impact of prescribed drugs until major health crises such as falls or other serious complications occur, which can result in hospitalisation. Methods: The aim of this study was to explore chronic pain prescribing in older adults, both in terms of the population itself and in terms of individual perceptions, experiences and overall needs. As such, two work packages were employed, firstly to explore the wider prescribing patterns using the CPRD database (quantitative work package), and secondly to explore individual experiences using qualitative interviews (qualitative work package). The mixed methods methodology included an epidemiological approach along with qualitative methodology and a discrete choice experiment. Ultimately, the final outcomes of this investigation will lead to adopting a codesigned intervention which will be evaluated in a later research programme. This protocol focuses on both the qualitative work package and the wider project, including a brief outline of the quantitative work package. A more detailed technical protocol for the quantitative work package is available in a linked publication.