• Dania Al-Masri, Kerry Wilbur, Shereen Elazzazy, Azza A Hassan, and Kyle J Wilby.
• Dania Al-Masri, BSc(Pharm), MSc(Pharm), is with the College of Pharmacy, Qatar University, Doha, Qatar; Kerry Wilbur, BSc(Pharm), ACPR, PharmD, MPH, is with the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada; Shereen Elazzazy, BSc(Pharm), PharmD, is with the Department of Pharmacy - Clinical Services, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Azza A. Hassan, MB BCh, MSc, MD, is with the Supportive & Palliative Care Unit, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Kyle J. Wilby, BSP, ACPR, PharmD, PhD, is with the School of Pharmacy, University of Otago, Dunedin, New Zealand.
• J Pain Palliat Care Pharmacother. 2020 Jun 1; 34 (2): 55-62.

AbstractStudies have shown barriers to appropriate narcotic use in the Middle East have negatively impacted patient outcomes. This study aimed to explore health professionals' perspectives regarding opioid use for cancer patients in Qatar. Eight focus groups were conducted with physicians, pharmacists, and nurses. An eight-question topic guide framed discussions and targeted contextual barriers and cultural beliefs. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis was used to identify the following themes: narcotic use process, patient-related factors, and healthcare professional-related factors. Laws and regulations were identified as major barriers to appropriate narcotic access, prescribing, and administration. Government-imposed restrictions on permitted dispensed quantities and associated paperwork impeded continuity of patient care and pain relief. The influence of a patient's culture underpinned patient-related barriers, including fear of addiction and family members discouraging opioid use. Fear of prescribing for patient addiction and accusation of inappropriate prescribing by authorities were identified as health professional-related barriers. Facilitators included patient and provider education, as well as the availability of specialized teams to assess and treat cancer-related pain. Findings show narcotic utilization is not simply influenced by a single factor or subset of factors but by a multitude of factors that can be both independent and interrelated.

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