General Practitioners' Barriers and Facilitators to Opioid Prescription in Medellin, Colombia (S810)

Abstract

1.Identify the attitudes and specific practices of general practitioners regarding opioid prescription.2.Recognize general practitioners' perceived barriers and facilitators of opioid prescription.3.Describe how general practitioners' knowledge of opioids influence opioid prescription. Understanding key attitudes, barriers and facilitators of opioid prescription can help overcome the current undertreatment of pain in Low and Middle-Income Countries (LMICs). Identify barriers and facilitators for opioid prescription by GPs in Medellin, Colombia. Descriptive-quantitative, cross-sectional study. A 53-item questionnaire was designed to assess: 1) attitudes (concerns and confidence when prescribing opioids), 2) practices related to opioid prescription, 3) perceived barriers and facilitators of opioid prescription; and 4) knowledge of opioids. We surveyed GPs who graduated from medical schools in Medellin, and GPs currently practicing in ten institutions in Medellin, Colombia. 179 participants completed the questionnaire. Descriptive and correlational analyses were conducted. The mean age was 33.3 years old (SD 10.43), 53.3% were female, 47.8% had been practicing for over 5 years, 51.66% did not receive training in pain management during medical school and only 2.8% received training after medical school. Regarding knowledge, 49.5% responded accurately. Common concerns were managing adverse effects and potential opioid abuse. Participants felt less confident to prescribe opioids to pediatric, pregnant patients, and those with history of substance abuse. Common barriers to opioid prescription were restriction to access, high costs, and insufficient training. Adequate opioid prescription practices were significantly and positively correlated with confidence when prescribing opioids (0.466; p<0.01), knowledge of opioids (0.422; p<0.01), age (0.233; p<0.01), and training in pain management (0.308; p<0.01); and significantly and negatively correlated with perceived barriers (-0.332; p<0.01). Adequate practices regarding opioid use are related to training, knowledge and confidence when prescribing opioids. However, GPs in our context have insufficient knowledge about pain control and opioid use.