General practitioner attitudes towards systems-level opioid prescribing interventions: A pooled secondary qualitative...

Area of Science:

• Medical Research
• Public Health Interventions
• Qualitative Analysis

Background:

• Australian systems-level initiatives have been implemented to curb opioid overprescribing.
• General practitioner (GP) attitudes towards these interventions require exploration.

Purpose of the Study:

• To explore general practitioner (GP) attitudes towards systems-level initiatives aimed at reducing opioid overprescribing.
• To understand GP perspectives on the effectiveness and acceptability of different interventions.

Main Methods:

• Secondary qualitative analysis of pooled interview data from 2018-2019.
• Thematic analysis and the Capability-Opportunity-Motivation (COM-B) model were used for data recoding.
• Participants included 57 GPs and general practice registrars from Victoria and New South Wales.

Main Results:

• GPs showed positive attitudes towards real-time prescription monitoring and codeine up-scheduling.
• Government-issued 'nudge' letters to high prescribers were perceived as paternalistic and potentially hindering adequate analgesia prescription.
• Guidelines and education were considered useful in theory but infrequently utilized.

Conclusions:

• Systems-level interventions for reducing opioid overprescribing may succeed more through GP partnership and by prioritizing prescriber motivation.
• Future interventions could benefit from addressing motivation through multiple mechanisms beyond single approaches.