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

Abstract

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. A cross-sectional study design. Large academic medical center. Physicians in inpatient and outpatient practice, as stratified by physician specialty for psychiatry or addiction medicine (Psych/AM), primary care, and others. A survey was administered electronically from July to September 2019, with survey items adapted from published opioid policy evaluations. Assessment of physician reason for the use of PDMP and perception of PDMP clinical utility. Responses by specialty were compared via chi square testing. 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). 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.