(136) Beliefs about prescribing opioids for chronic pain: survey of primary care providers

Abstract

There is growing concern among primary care providers (PCPs) of medication misuse and noncompliance among chronic pain patients prescribed opioids for pain. This survey study is part of a larger investigation on improving provider confidence in managing chronic pain patients through the use of specialty support, risk assessment, and summary reports. Forty-five (N=45) primary care providers completed a packet of questionnaires about attitudes and concerns about opioids for chronic pain including the Concerns About Analgesic Prescription Questionnaire. The providers also completed background information, the General Health Questionnaire, and the Knowledge of OpioidsTest (KOT). Ages ranged between 27 and 64 (average 43 years), 58% were female, and 82% were Caucasian. In general, the PCPs showed adequate opioid knowledge on the KOT (averaging 17 of 25 items correct) and general health was unrelated to prescription attitudes. Most expressed concern about medication misuse (90%) and felt that managing chronic pain patients was stressful (84%). Most were worried about addiction (82%) and less than half felt that they were sufficiently trained in prescribing opioids (44%).Many also felt that theywere not satisfiedwith the support and communication they received from pain specialists in managing their chronic pain patients (67%). Younger providers felt more reluctant to prescribe opioids, experiencedmore stress in managing pain patients, had less overall confidence in managing pain patients, and worried more about dependence than older providers (p<0.05). Younger providerswere also less knowledgeable about opioids, but opioid knowledge was not found to be related to concerns about analgesic prescriptions. An ongoing study will continue to track providers and patients to help determine whether careful patient monitoring and incorporation of a structured opioid therapy protocol (risk assessment, periodic urine screens, and compliance checklists) will reduce opioid misuse within primary care. This survey was partially supported by a grant from Mallinckrodt.