To Örebro University

Objective: To explore general practitioners' (GP) experiences of dealing with requests for the renewal of weak opioid prescriptions for chronic non-cancer pain conditions.

Design: Qualitative focus group interviews. Systematic text condensation analysis.

Setting and subjects: 15 GPs, 4 GP residents and 2 interns at two rural and two urban health centres in central Sweden.

Main outcome measures: Strategies for handling the dilemma of prescribing weak opioids without seeing the patient.

Results: After analysing four focus group interviews we found that requests for prescription renewals for weak opioids provoked adverse feelings in the GP regarding the patient, colleagues or the GP's inner self and were experienced as a dilemma. To deal with this, the GP could use passive as well as active strategies. Active strategies, like discussing the dilemma with colleagues and creating common routines regarding the renewal of weak opioids, may improve prescription habits and support physicians who want to do what is medically correct.

Conclusion: Many GPs feel umcomfortable when prescribing weak opioids without seeing the patient. This qualitative study has identified strategic approaches to deal with that issue.