People with arthritis-disability and provider experiences with chronic opioid therapy: A qualitative inquiry

Growing concerns about opioid overprescribing, opioid use disorder (OUD), and overdose led to opioid misuse prevention practices that may impact the lives of people with disability (PWD) and chronic pain.

To investigate the experiences of providers and people with arthritis related disability with opioid prescribing and monitoring following release of the Centers for Disease Control and Prevention Guideline for prescribing opioids for chronic pain.

We conducted semi-structured interviews with 24 specialists and primary care providers and 24PWD. Providers were required to prescribe opioids to people with arthritis-disability. PWD were required to have arthritis-disability causing chronic pain and to be on chronic opioid therapy (COT) or have been treated for OUD. We used a deductive and inductive analytic approach to develop themes.

Providers recommended COT when other pain treatment options were exhausted or unaffordable. PWD reported their provider recently reduced their opioid treatment intensity and frequent visits were required. PWD didn't remember or recalled hearing limited information about opioid risks and benefits. Some PWD were unsure if the benefits of opioids outweighed the risks. Few providers identified chronic pain care considerations specific to PWD.

Our findings facilitate a better understanding of the challenges faced by PWD living with chronic pain and their providers related to COT. The findings show the need for better informing PWD about the risks and benefits of opioids prior to initiating treatment, training on person-centered care tailored to PWD's unique needs and improved coverage of nonopioid treatments for chronic pain.