Beliefs and attitudes about prescribing opioids among healthcare providers seeking continuing medical education

Authors

  • W. Michael Hooten, MD
  • Barbara K. Bruce, PhD

DOI:

https://doi.org/10.5055/jom.2011.0082

Keywords:

prescription opioid, chronic pain, continuing medical education, attitudes and beliefs, healthcare providers

Abstract

Objective: The purpose of this study was to assess the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain.
Setting: The setting was a continuing medical education conference that was specifically designed to deliver content about chronic pain and prescription opioids to providers without specialty expertise in pain medicine.
Participants: Conference attendees with prescribing privileges were eligible to participate, including physicians, physician assistants, and advance practice nurses.
Intervention: Study participants completed a questionnaire using an electronic response system.
Main outcome measures: Study participants completed a validated questionnaire that was specifically developed to measure the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain.
Results: The questionnaire was completed by 128 healthcare providers. The majority (58 percent) indicated that they were “likely” to prescribe opioids for chronic pain. A significant proportion of respondents had favorable beliefs and attitudes toward improvements in pain (p < 0.001) and quality of life (p < 0.001) attributed to prescribing opioids. However, a significant proportion had negative beliefs and attitudes about medication abuse (p < 0.001) and addiction (p < 0.001). Respondents also indicated that prescribing opioids could significantly increase the complexity of patient care and could unfavorably impact several administrative aspects of clinical practice.
Conclusions: The beliefs and attitudes identified in this study highlight important educational gaps that exist among healthcare providers about prescribing opioids. Knowledge of these educational gaps could build the capacity of medical educators to develop targeted educational materials that could improve the opioid prescribing practices of healthcare providers.

Author Biographies

W. Michael Hooten, MD

Associate Professor, Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota; Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota.

Barbara K. Bruce, PhD

Associate Professor, Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota.

References

Hutchinson K, Moreland AM, de C Williams AC, et al.: Exploring beliefs and practice of opioid prescribing for persistent non-cancer pain by general practitioners. Eur J Pain. 2007; 11: 93-98.

Morley-Forster PK, Clark AJ, Speechley M, et al.: Attitudes toward opioid use for chronic pain: A Canadian physician survey. Pain Res Manag. 2003; 8: 189-194.

Nwokeji ED, Rascati KL, Brown CM, et al.: Influences of attitudes on family physicians’ willingness to prescribe long-acting opioid analgesics for patients with chronic nonmalignant pain. Clin Ther. 2007; 29 (Suppl): 2589-2602.

Ponte CD, Johnson-Tribino J: Attitudes and knowledge about pain: An assessment of West Virginia family physicians. Fam Med. 2005; 37: 477-480.

Potter M, Schafer S, Gonzalez-Mendez E, et al.: Opioids for chronic nonmalignant pain. Attitudes and practices of primary care physicians in the UCSF/Stanford Collaborative Research Network. University of California, San Francisco. J Fam Pract. 2001; 50: 145-151.

Upshur CC, Luckmann RS, Savageau JA: Primary care provider concerns about management of chronic pain in community clinic populations. J Gen Intern Med. 2006; 21: 652-655.

O’Rorke JE, Chen I, Genao I, et al.: Physicians’ comfort in caring for patients with chronic nonmalignant pain. Am J Med Sci. 2007; 333: 93-100.

Phelan SM, van Ryn M, Wall M, et al.: Understanding primary care physicians’ treatment of chronic low back pain: The role of physician and practice factors. Pain Med. 2009; 10: 1270-1279.

Duensing L, Eksterowicz N, Macario A, et al.: Patient and physician perceptions of treatment of moderate-to-severe chronic pain with oral opioids. Curr Med Res Opin. 2010; 26: 1579-1585.

Lin JJ, Alfandre D, Moore C: Physician attitudes toward opioid prescribing for patients with persistent noncancer pain. Clin J Pain. 2007; 23: 799-803.

Bhamb B, Brown D, Hariharan J, et al.: Survey of select practice behaviors by primary care physicians on the use of opioids for chronic pain. Curr Med Res Opin. 2006; 22: 1859-1865.

Ballantyne JC, LaForge KS: Opioid dependence and addiction during opioid treatment of chronic pain. Pain. 2007; 129: 235-255.

Passik SD, Webster LR: Pain and addiction interface. Pain Med. 2008; 9: 631-633.

Sullivan MD, Von Korff M, Banta-Green C, et al.: Problems and concerns of patients receiving chronic opioid therapy for chronic non-cancer pain. Pain. 2010; 149: 345-353.

Peppin JF: The marginalization of chronic pain patients on chronic opioid therapy. Pain Physician. 2009; 12: 493-498.

Passik SD: Issues in long-term opioid therapy: Unmet needs, risks, and solutions. Mayo Clin Proc. 2009; 84: 593-601.

Wolfert MZ, Gilson AM, Dahl JL, et al.: Opioid analgesics for pain control: Wisconsin physicians’ knowledge, beliefs, attitudes, and prescribing practices. Pain Med. 2010; 11: 425-434.

Varrassi G, Muller-Schwefe G, Pergolizzi J, et al.: Pharmacological treatment of chronic painÑThe need for CHANGE. Curr Med Res Opin. 2010; 26: 1231-1245.

Gilson AM, Maurer MA, Joranson DE: State medical board members’ beliefs about pain, addiction, and diversion and abuse: A changing regulatory environment. J Pain. 2007; 8: 682-691.

Ballantyne JC: Opioid controls: Regulate to educate. Pain Med. 2010; 11: 480-481.

Ballantyne JC: Regulation of opioid prescribing. BMJ. 2007; 334: 811-812.

Published

11/01/2017

How to Cite

Hooten, MD, W. M., and B. K. Bruce, PhD. “Beliefs and Attitudes about Prescribing Opioids Among Healthcare Providers Seeking Continuing Medical Education”. Journal of Opioid Management, vol. 7, no. 6, Nov. 2017, pp. 417-24, doi:10.5055/jom.2011.0082.