Helping to optimise pain control in the elderly experiencing analgesic overprescribing

The aim of the study is to explore chronic pain prescribing in older adults, both in terms of the population itself, and in terms of their experiences and overall needs.

Ob1: Understand which sociodemographic (e.g. age [above 65+], gender, deprivation, rurality, ethnicity) and clinical (e.g. mental health, multimorbidity, co-prescribing) factors are associated with prescribing of key analgesic drug classes (i.e. weak opioids, strong opioids, NSAIDs, paracetamol, gabapentinoids, low-dose tricyclics), combinations of these drug classes, and changes over time. (WP1)
Ob2: Investigate the association between the aforementioned analgesic drug classes (including clusters of drug classes and temporal changes), and important clinical and health service outcomes (particularly adverse outcomes). (WP1)
Ob3: Identify alternative treatment solutions to reduce the use of unnecessary analgesic pain medicines through exploring older adults and their caregiver’s: acceptability of currently used analgesic pain medicines (and other pharmacological agents for mood or sleep aspects of chronic pain); their current use; their trust of different prescribing professionals; and their willingness to try and accept other pain management modalities (e.g. self management, non-pharmacological, safer pharmacological options) (WP2).
Ob4: Identify the current barriers and facilitators for optimising, deprescribing, and preventing unnecessary prescribing of analgesic pain medicines for older adults through exploring the experiences of health professional prescribers managing medicines for older adults living with chronic pain in the primary care setting. (WP2)
Ob5: Identify potential engagement strategies, prior to support, which can aid the optimisation and deprescription of unnecessary prescribing of analgesic pain medicines through exploring older adults, their caregivers and health professional prescribers (primary care) understanding of analgesic pain medicine risks and their willingness to engage in the optimisation and deprescription of unnecessary analgesic pain medicines. (WP2)
Ob6: Develop a prioritised list of acceptable engagement strategies and alternative treatment solutions to reduce use of analgesics and increase use of self-management, non-pharmacological or safer pharmacological options to manage chronic pain which can be tested in a future intervention, using the accounts of key stakeholders (older people, their caregivers and health professional prescribers). (WP2).