Primary care physicians’ opioid-related prevention behaviors and intentions: A descriptive analysis

Tyler C. Melton, PharmD, MPH, BCPS; Nicholas E. Hagemeier, PharmD, PhD; Fred G. Tudiver, MD; Kelly N. Foster, PhD; Jessie Arnold, MA; Bill Brooks, DrPH, MPH; Arsham Alamian, PhD, MSc, FACE; Robert P. Pack, PhD, MPH

doi:10.5055/jom.2022.0697

Authors

Tyler C. Melton, PharmD, MPH, BCPS https://orcid.org/0000-0003-4517-8171
Nicholas E. Hagemeier, PharmD, PhD
Fred G. Tudiver, MD
Kelly N. Foster, PhD
Jessie Arnold, MA
Bill Brooks, DrPH, MPH
Arsham Alamian, PhD, MSc, FACE
Robert P. Pack, PhD, MPH

DOI:

https://doi.org/10.5055/jom.2022.0697

Keywords:

primary care physicians, opioid use disorder, primary prevention, secondary prevention, tertiary prevention

Abstract

Objective: Primary care physicians (PCPs) are positioned to mitigate opioid morbidity and mortality, but their engagement in primary, secondary, and tertiary opioid-related prevention behaviors is unclear. The objective of this study was to evaluate Tennessee PCPs’ engagement in and intention to engage in multiple opioid-related prevention behaviors.

Methods: A survey instrument was developed, pretested, and pilot tested with practicing PCPs. Thereafter, a census of eligible Tennessee PCPs was conducted using a modified, four-wave tailored design method approach. Three patient scenarios were employed to assess physician intention to engage in 10 primary, secondary, and tertiary prevention behaviors. Respondents were asked to report, given 10 similar scenarios, the number of times (0-10) they would engage in prevention behaviors. Descriptive statistics were calculated using SPSS version 25.

Results: A total of 296 usable responses were received. Physician intention to engage in prevention behaviors varied across the 10 behaviors studied. Physicians reported frequently communicating risks associated with prescription opioids to patients (8.9 ± 2.8 out of 10 patients), infrequently utilizing brief questionnaires to assess for risk of opioid misuse (1.7 ± 3.3 out of 10 patients), and screening for current opioid misuse (3.1 ± 4.3 out of 10 patients). Physicians reported seldomly co-prescribing naloxone for overdose reversal and frequently discharging from practice patients presenting with an opioid use disorder.

Conclusions: This study noted strengths and opportunities to increase engagement in prevention behaviors. Understanding PCPs’ engagement in opioid-related prevention behaviors is important to effectively target and implement morbidity and mortality reducing interventions.

Author Biographies

Tyler C. Melton, PharmD, MPH, BCPS

Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee

Nicholas E. Hagemeier, PharmD, PhD

Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee

Fred G. Tudiver, MD

Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee

Kelly N. Foster, PhD

Department of Sociology and Anthropology, East Tennessee State University, Johnson City, Tennessee

Jessie Arnold, MA

Department of Sociology and Anthropology, East Tennessee State University, Johnson City, Tennessee

Bill Brooks, DrPH, MPH

College of Public Health, East Tennessee State University, Johnson City, Tennessee

Arsham Alamian, PhD, MSc, FACE

School of Nursing and Health Studies, University of Miami, Coral Gables, Florida

Robert P. Pack, PhD, MPH

College of Public Health, East Tennessee State University, Johnson City, Tennessee

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