Perceived barriers to and facilitators of opioid use in the emergency department
| Barrier/facilitator | No. (%) of respondents* n = 136 |
|---|---|
| Barriers | |
| Parental reluctance | 57 (41.9) |
| Lack of clear guidelines for opioid use in children | 35 (25.7) |
| Concern about adverse effects | 33 (24.3) |
| Concern about serious adverse events | 30 (22.1) |
| Regulation of prescribing opioids (e.g., triplicate prescription needed) | 29 (21.3) |
| Assessing pain in younger children is difficult | 27 (19.8) |
| Lack of comfort with medication dosing | 21 (15.4) |
| Policy regarding nursing/monitoring of patients who receive opioids | 21 (15.4) |
| Concern for opioid use disorders and addiction | 18 (13.2) |
| Lack of adequate research to guide practice | 17 (12.5) |
| Consultant preference | 16 (11.8) |
| Concern for opioid dependence | 13 (9.6) |
| Fear that opioids can mask symptoms and lead to missed diagnoses | 3 (2.2) |
| Other | 5 (3.7) |
| Facilitators | |
| Personal clinical experience with opioid use in children | 108 (79.4) |
| Opportunity to monitor patients in emergency department | 90 (66.2) |
| Parental approval and understanding of benefits/adverse effects of opioids | 60 (44.1) |
| Good research available on opioid use in children | 51 (37.5) |
| Documented pain scores | 51 (37.5) |
| Opioid-specific protocols in institution/emergency department | 47 (34.6) |
| Patient known to be not opioid naive and has used opioids safely in the past | 35 (25.7) |
| Other | 2 (1.5) |
↵* Multiple responses were permitted.