Abstract
BACKGROUND: There is insufficient evidence to indicate using opioids in the management of chronic non-cancer pain (CNCP), yet ongoing prescribing is prevalent and remains a global public health matter. Inappropriate long-term prescribing of opioids is associated with side effects and adverse events. This article explores the significant barriers and enablers during opioid management indicated for CNCP within general practice, in the United Kingdom, and proposes recommendations to optimise practice. METHODS: A systematic literature review of the databases MEDLINE, EMBASE, CINAHL, Web of Science and Science Direct were searched. Titles, abstracts and full texts were screened against inclusion and exclusion criteria. Papers were evaluated using the Critical Appraisal Skills Programme qualitative appraisal tool. RESULTS: From 1027 citations, 6 papers were included (n practitioners = 168 and n patients = 52). Four key themes were identified: three barriers and one enabler. Barriers: general practice healthcare model constraints, relationships in primary care and attitudes towards CNCP management. Enabler: multidisciplinary team set up. CONCLUSION: A change in culture from both service providers and service users is required to fully embrace the multidisciplinary team observed in general practice. Movement away from the traditional model of doctor led management needs to occur. Future policies need to prioritise reducing the long waiting times observed for specialist pain services. Non-pharmacological opportunities and services should also be developed to support patients.