From Westat, Inc. Rockville, MD (SMP, LR, SS); U.S. Food and Drug Administration, Silver Spring, MD (ACO, KJA).
J Am Board Fam Med. 2021 Jul-Aug;34(4):802-807. doi: 10.3122/jabfm.2021.04.200610.
Lack of training among health care providers (HCPs) to safely prescribe opioids is a contributing factor to the opioid crisis. Training and other resources have been developed to educate providers about safe and appropriate opioid prescribing practices.
The national survey was conducted with 2000 HCPs representing primary care physicians (PCPs), including family practice, general practice, and internal medicine; specialists (SPs); physician assistants (PAs); and nurse practitioners (NPs), a mix of primary care and specialists. This survey examined exposure to opioid educational information and opioid prescribing.
PCPs reported prescribing opioids for chronic pain to significantly more patients compared with other HCP groups. PCPs (89.8%) and NPs (85.5%) reported significantly greater exposure to opioid educational information compared with both SPs (71.9%) and PAs (78.8%). Overall, HCPs had limited knowledge about abuse-deterrent formulations, but PCPs had greater knowledge than other groups. HCPs had an increased likelihood of prescribing opioids to fewer patients in the last 3 months relative to the prior 12 months if they worked in a state or county clinic vs a solo or group practice type (adjusted odds ratio [AOR] = 1.97; 95% confidence interval [CI], 1.12-3.49) and were exposed to more opioid educational information during the last 12 months (AOR = 1.19; 95% CI, 1.06-1.32).
HCPs' exposure to opioid educational information was associated with less opioid prescribing for chronic pain. Findings indicated a difference in exposure and knowledge gaps across provider groups. More information is needed on the content of opioid educational information provided to HCPs.
医疗保健提供者（HCP）缺乏安全开处阿片类药物的培训是阿片类药物危机的一个促成因素。已经开发了培训和其他资源，以教育提供者有关安全和适当的阿片类药物处方实践。
这项全国性调查是在 2000 名 HCP 中进行的，他们代表初级保健医生（PCP），包括家庭医生、全科医生和内科医生；专家（SP）；医师助理（PA）；和执业护士（NP），包括初级保健和专家。这项调查考察了接触阿片类药物教育信息和阿片类药物处方的情况。
与其他 HCP 群体相比，PCP 报告为慢性疼痛开处阿片类药物的患者明显更多。与 SP（71.9%）和 PA（78.8%）相比，PCP（89.8%）和 NP（85.5%）报告接触阿片类药物教育信息的情况明显更多。总体而言，HCP 对滥用预防配方的了解有限，但 PCP 比其他群体的了解更多。如果他们在州或县诊所工作，而不是在个体或团体实践类型中工作，HCP 在过去 3 个月内开处阿片类药物的患者人数减少的可能性增加（调整后的优势比[OR] = 1.97；95%置信区间[CI]，1.12-3.49），并且在过去 12 个月内接触到更多的阿片类药物教育信息（OR = 1.19；95% CI，1.06-1.32）。
HCP 接触阿片类药物教育信息与慢性疼痛的阿片类药物处方减少有关。研究结果表明，各提供者群体之间存在接触和知识差距。需要更多关于向 HCP 提供的阿片类药物教育信息的内容的信息。
