Perceptions of patients and health care professionals on postoperative pain management: Key factors influencing persistent opioid use

Objective

This study applied the Theoretical Domains Framework (TDF) to explore the barriers and enablers to optimizing post-operative pain management and supporting safe opioid use from the perspectives of both patients and health care professionals, applying the Theoretical Domains Framework (TDF).

Design

Experience-based co-design (EBCD) qualitative study.

Methods

In the initial phase of the EBCD approach, focus groups were conducted comprising 20 participants, including 8 patients and 12 health care professionals involved in post-operative care. The data were systematically analysed using framework analysis and mapped to the TDF. Intervention functions and behaviour change techniques (BCTs) targeting each TDF domain were identified.

Results

Analysis revealed significant barriers faced by patients, including a lack of continuity in care, inadequate preoperative preparation, and insufficient guidance on opioid tapering. Health care professionals reported barriers associated with deficiencies in knowledge, skills, and environmental resources, particularly workforce constraints and ineffective communication across care settings. Notable enablers included pharmacist-led medication reviews and the adoption of digital technologies to enhance education and support tapering.

Conclusions

This study identifies critical barriers and facilitators that influence postoperative pain management and opioid use. Targeted interventions are imperative to optimize these outcomes. Key recommendations include implementing pharmacist-led medication reviews, integrating digital tapering support tools and enhancing preoperative educational efforts. Furthermore, strengthening communication pathways and addressing workforce challenges through dedicated training and resource allocation are essential. Future research should assess the efficacy of these tailored interventions across diverse clinical contexts to improve patient outcomes and refine prescribing practices.