A survey assessment of clinician perceptions of opioid supply and monitoring requirement policy changes

Abstract

Objective: Florida-mandated Prescription Drug Monitoring Program (PDMP) use and restricted Schedule II opioid dispensing for acute pain to 3-day supply in 2018. This study assessed physician perception of these policies.

Design: A cross-sectional study design.

Setting: Large academic medical center.

Patients/participants: Physicians in inpatient and outpatient practice, as stratified by physician specialty for psychiatry or addiction medicine (Psych/AM), primary care, and others.

Interventions: A survey was administered electronically from July to September 2019, with survey items adapted from published opioid policy evaluations.

Main outcome measure: Assessment of physician reason for the use of PDMP and perception of PDMP clinical utility. Responses by specialty were compared via chi square testing.

Results: There were N = 214 responses (response rate ~10.9 percent), representing n = 15 from Psych/AM, n = 58 primary care, and n = 143 from other specialties. The most frequently reported reason for PDMP use across specialties was to examine prescribing history for patients currently using opioid analgesics (6.7 percent Psych/AM; 50.1 percent primary care; 38.6 percent others; p = 0.027). Fewer Psych/AM physicians agreed that the policy hinders the clinical work day as compared with primary care physicians (46.7 percent vs. 58.6 percent). More primary care agreed the policy was a good idea relative to Psych/AM (62.1 percent vs. 53.3 percent). More primary care than Psych/AMs agreed that the policy made it more challenging for chronic pain patients to access opioid therapies (77.6 percent vs. 53.3 percent).

Conclusions: The perceived workflow burden and unintended consequence of decreased chronic pain patient access to opioid pharmacotherapies suggest further opportunities for pharmacist–physician collaboration in managing affected patients.