Opioid prescribing knowledge and practices: provider survey following promulgation of guidelines-Utah, 2011.

OBJECTIVE

The Utah Department of Health published the Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain in 2010. The objective was to evaluate the impact of the Guidelines on provider behaviors such as documentation and use of screening tools.

SETTING

Web-based questionnaire about opioid prescribing knowledge and practices distributed among 85 providers of a university-based, primary care community clinic system in the summer of 2011.

MAIN OUTCOME MEASURES

Provider-reported knowledge about and comfort prescribing opioids and use of tools for managing opioid patients.

RESULTS

Forty-seven providers who prescribe opioids on an outpatient basis completed the questionnaire after an initial e-mail invitation and two reminders (55 percent response rate). Providers most often used simple rating scales that can be included easily in the notes of the electronic medical record (EMR) to assess pain. When treating patients with chronic pain, 26 percent of respondents reported that they did not use any tool for patient assessment prior to treatment. Providers desire more training in opioid prescribing and feel that they lack referral resources for patients with chronic, noncancer pain. Prescription monitoring program use was common with 77 percent of providers reporting that they would access the system before prescribing opioids for a new patient.

CONCLUSIONS

System-level changes such as inclusion of screening tools into EMRs will be needed to improve compliance with the Guidelines. Providers find treatment of chronic pain to be challenging and something for which they desire additional training and referral support.