• Cara L Sedney, Patricia Dekeseredy, Sarah A Singh, and Monika Holbein.
• Department of Neurosurgery (C.L.S., P.D.), Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA. Electronic address: csedney@hsc.wvu.edu.
• J Pain Symptom Manage. 2023 Jun 1; 65 (6): 553561553-561.

ContextStigma is known to impact the care of patients with opioid use disorder (OUD).ObjectivesThis qualitative study seeks to understand how stigma is expressed in the medical chart by healthcare workers towards patients with cancer pain and OUD treated at an academic medical center.MethodsThis descriptive qualitative study utilized a thematic analysis approach to analyze the medical charts of 25 hospitalized patients with current or previous opioid use disorder and cancer with respect to their pain care in forty pain-related hospital admissions to a tertiary academic center from 2015 to 2020. The codebook utilized a well-characterized stigma framework and emerging themes were identified through an iterative, comparative method. COREQ guidelines were followed.ResultsEvidence of stigma marking was present in the medical chart aligning with several intersecting stigmas. Drivers such as blame and stereotypes impeded pain care, while facilitators such as legal or policy influences and non-care advocates could be either positive or negative determinants to pain care. Care by known providers within the healthcare environment was largely a facilitator of improved pain care.ConclusionsHealthcare provider stigma must be addressed as its effects are both quantitatively and qualitatively affecting patient care; in particular access to pain treatment. Continuity of care by known care providers may improve pain care for patients with cancer and OUD who are acutely hospitalized.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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