Click Ivy A, Basden Jeri Ann, Bohannon Joy M, Anderson Heather, Tudiver Fred
a Department of Family Medicine , East Tennessee State University , Johnson City , Tennessee , USA.
b Institutional Effectiveness, Research, Planning & Assessment , Volunteer State Community College , Gallatin , Tennessee , USA.
Subst Use Misuse. 2018 Mar 21;53(4):533-540. doi: 10.1080/10826084.2017.1342659. Epub 2017 Aug 31.
Rural Tennessee, especially rural East Tennessee has seen a dramatic increase in rates of controlled drug prescriptions and controlled drug overdose deaths in recent years. However, little is known about the individual decisions to prescribe or continue prescriptions with relation to addiction concerns.
The purpose of this study was to learn more about what factors lead to physicians' prescribing control drugs for non-cancer pain through the use of focus groups.
A qualitative study, using focus groups, in five family medicine clinics in East Tennessee and Southwest Virginia. The investigators used a semi-structured interview guide designed to facilitate group discussions about prescription drug abuse and misuse.
There were four main themes identified by the focus groups: (1) prescribers' changing prescribing patterns over time; (2) factors that influence controlled drug prescribing; (3) use and barriers to using state prescription drug monitoring programs (PDMPs); (4) prescribing controlled drugs to women of childbearing age. Each theme had several subthemes.
The balance between treating the patient's symptoms and causing potential harm is a challenge. The patient's pain cannot be ignored, but the potential harm of opioid therapy is not taken lightly. As the public health concern of prescription drug abuse in rural Appalachia continues to spread, prescribers are aware of their connection to the problem, and ultimately the solution.
田纳西州农村地区，尤其是东田纳西州农村，近年来受控药物处方率和受控药物过量致死率急剧上升。然而，对于与成瘾问题相关的处方开具或继续开具处方的个体决策，人们知之甚少。
本研究的目的是通过焦点小组了解更多导致医生为非癌性疼痛开具受控药物的因素。
在东田纳西州和弗吉尼亚州西南部的五家家庭医学诊所进行了一项使用焦点小组的定性研究。研究人员使用了一份半结构化访谈指南，旨在促进关于处方药滥用和误用的小组讨论。
焦点小组确定了四个主要主题：（1）开处方者随时间变化的处方模式；（2）影响受控药物处方的因素；（3）州处方药监测计划（PDMPs）的使用及使用障碍；（4）为育龄妇女开具受控药物。每个主题都有几个子主题。
在治疗患者症状与造成潜在伤害之间取得平衡是一项挑战。患者的疼痛不能被忽视，但阿片类药物治疗的潜在危害也不能掉以轻心。随着阿巴拉契亚农村地区对处方药滥用的公共卫生关注持续蔓延，开处方者意识到他们与该问题的关联，以及最终的解决办法。
