Opioid Policy and Chronic Pain Treatment Access Experiences: A Multi-Stakeholder Qualitative Analysis and Conceptual Model Article Swipe
Stephanie Slat
,
Avani Yaganti
,
Jennifer Thomas
,
Danielle Helminski
,
Michele Heisler
,
Amy S. B. Bohnert
,
Pooja Lagisetty
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.2147/jpr.s282228
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.2147/jpr.s282228
Stephanie Slat,1 Avani Yaganti,1 Jennifer Thomas,1 Danielle Helminski,1 Michele Heisler,1– 4 Amy Bohnert,2,4,5 Pooja Lagisetty1,2,4 1Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; 2Center for Clinical Management and Research, Ann Arbor VA Hospital, Ann Arbor, MI, USA; 3Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA; 4Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; 5Departments of Anesthesiology and Psychiatry, University of Michigan, Ann Arbor, MI, USACorrespondence: Stephanie SlatDepartment of Internal Medicine, University of Michigan, NCRC B16-Floor 4, 2800 Plymouth Road, Ann Arbor, MI, 48109, USATel +1 734-755-1574Email [email protected]: Patients on long-term opioid therapy (LTOT) for pain have difficulty accessing primary care clinicians who are willing to prescribe opioids or provide multimodal pain treatment. Recent treatment guidelines and statewide policies aimed at reducing inappropriate prescribing may exacerbate these access issues, but further research is needed on this issue. This study aimed to understand barriers to primary care access and multimodal treatment for chronic pain from the perspective of multiple stakeholders.Methods: Qualitative, semi-structured phone interviews were conducted with adult patients with chronic pain, primary care clinicians, and clinic office staff in Michigan. Interview questions covered stakeholder experiences with prescription opioids, opioid-related policies, and access to care for chronic pain. Interviews were coded using inductive and deductive methods for thematic analysis.Results: A total of 25 interviews were conducted (15 patients, 7 primary care clinicians, and 3 office staff). Barriers to treatment access were attributed to six themes: (1) reduced clinic willingness to manage prescribed opioids for new patients; (2) lack of time and reimbursement for quality opioid-related care; (3) paucity of multimodal care and coordination between providers; (4) fear of liability and use of new guidelines to justify not prescribing opioids; (5) delayed prescription receipt due to prior authorization and pharmacy issues; and (6) poor availability of effective non-opioid treatments.Conclusion: Issues of policy, logistics, and clinic-level resources converge to disrupt treatment access for patients with chronic pain, as many clinics both do not offer multimodal pain care and are unwilling to prescribe LTOT. The resulting conceptual model can inform the development of policy interventions to help mitigate these access barriers.Keywords: opioid, chronic pain, access, primary care, policy
Related Topics
Concepts
Medicine
Chronic pain
Prior authorization
Thematic analysis
Reimbursement
Stakeholder
Medical prescription
Qualitative research
Receipt
Pharmacy
Nursing
Phone
Family medicine
Health care
Psychiatry
Public relations
Computer science
Social science
Economics
Linguistics
World Wide Web
Economic growth
Political science
Sociology
Philosophy
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2147/jpr.s282228
- https://www.dovepress.com/getfile.php?fileID=68836
- OA Status
- gold
- Cited By
- 29
- References
- 35
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3157861607
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3157861607Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.2147/jpr.s282228Digital Object Identifier
- Title
-
Opioid Policy and Chronic Pain Treatment Access Experiences: A Multi-Stakeholder Qualitative Analysis and Conceptual ModelWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-04-01Full publication date if available
- Authors
-
Stephanie Slat, Avani Yaganti, Jennifer Thomas, Danielle Helminski, Michele Heisler, Amy S. B. Bohnert, Pooja LagisettyList of authors in order
- Landing page
-
https://doi.org/10.2147/jpr.s282228Publisher landing page
- PDF URL
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https://www.dovepress.com/getfile.php?fileID=68836Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
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https://www.dovepress.com/getfile.php?fileID=68836Direct OA link when available
- Concepts
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Medicine, Chronic pain, Prior authorization, Thematic analysis, Reimbursement, Stakeholder, Medical prescription, Qualitative research, Receipt, Pharmacy, Nursing, Phone, Family medicine, Health care, Psychiatry, Public relations, Computer science, Social science, Economics, Linguistics, World Wide Web, Economic growth, Political science, Sociology, PhilosophyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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29Total citation count in OpenAlex
- Citations by year (recent)
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2025: 9, 2024: 4, 2023: 6, 2022: 7, 2021: 3Per-year citation counts (last 5 years)
- References (count)
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35Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.Lagisetty1,2,4 | 14 |
| abstract_inverted_index.SlatDepartment | 84 |
| abstract_inverted_index.opioid-related | 205, 270 |
| abstract_inverted_index.semi-structured | 177 |
| abstract_inverted_index.734-755-1574Email | 103 |
| abstract_inverted_index.analysis.Results: | 224 |
| abstract_inverted_index.USACorrespondence: | 82 |
| abstract_inverted_index.barriers.Keywords: | 363 |
| abstract_inverted_index.stakeholders.Methods: | 175 |
| abstract_inverted_index.treatments.Conclusion: | 313 |
| abstract_inverted_index.Heisler,1– | 9 |
| [email protected]: | 104 |
| cited_by_percentile_year.max | 99 |
| cited_by_percentile_year.min | 95 |
| corresponding_author_ids | https://openalex.org/A5005712892 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 7 |
| corresponding_institution_ids | https://openalex.org/I27837315 |
| citation_normalized_percentile.value | 0.93639716 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |