The opioid epidemic and the impact on opioid prescribing in hospice and palliative care: a qualitative study

Abstract

Background: In the US, rising rates of opioid abuse has led to regulatory policies designed to curb opioid prescribing. While these policies generally exclude hospice and palliative care from prescribing restrictions, it is not known if these policies have had unintended consequences that affect opioid prescribing within hospice and palliative care. Methods: A qualitative, descriptive design, guided by the Theory of Planned Behaviour, was utilised to conduct a study to answer the following two research questions: 1) How has the opioid epidemic and related policies affected opioid prescribing practises among hospice and palliative care clinicians? and 2) How do hospice and palliative care clinicians perceive patients' end-of-life care has been impacted by the opioid epidemic and related policies? Findings: Ten clinicians, comprising physicians and nurse practitioners working in hospice and palliative care settings, were directly interviewed one-on-one. Data analysis revealed that the opioid epidemic and related policies have had an impact on the patient, clinician, nursing and hospice and palliative care speciality. Conclusions: As the broader medical community shifts away from opioid prescribing, care must be taken to ensure that hospice and palliative care patients still receive access to needed medications. Education is needed to assure that the relief of human suffering at end of life is prioritised.