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Table 3 Specific Barriers and Facilitators to Opioid Prescribing in Older Adults

From: Primary care providers' perspective on prescribing opioids to older adults with chronic non-cancer pain: A qualitative study

Themes Participants mentioning
(N = 26) n (%)
Newly identified theme*
Provider-level barriers   
   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   
   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
   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
  1. *Studies focused on barriers in adult populations with chronic pain (not older adult populations).