Changes in Opioid Prescribing for Chronic Pain in Washington State

Details

• Personal Author:
  Franklin GM ; Fulton-Kehoe D ; Sullivan MD ; Turner JA ; Wickizer TM
• Description:
  Purpose: To conduct a survey of primary care physicians and advanced registered nurse practitioners (ARNPs) in Washington State (WA) focused on changes in practice patterns and use of support tools in the prescription of opioids for the treatment of chronic noncancer pain (CNCP). Methods: A convenience sample of primary care providers in WA was obtained from diverse geographic regions and health care organizations. The web-based anonymous survey was conducted in March-August 2011. Results: Among 856 provider respondents, 623 reported treating patients with CNCP and served as the analysis sample. Most providers (72%) reported concern about opioid overdose, addiction, dependence, or diversion. Only 25% indicated concern about regulatory scrutiny. Only a small proportion of providers overall (3.3%) reported that they had stopped prescribing opioids for CNCP, but twice as many ARNPs (5.8%) as physicians (MDs and osteopaths) (2.1%) reported this. A greater proportion of physicians (70.9%) than ARNPs (40.1%) reported familiarity with the Washington State opioid dosing guidelines. Physicians in a large health plan with substantial infrastructure support reported less concern about opioids compared with providers in other settings. Of providers in Spokane (the largest city in Eastern Washington), 45% reported very low capacity to access pain specialty consultation. The vast majority of providers reported a need to access more efficient, innovative means of support and education related to treating patients with CNCP, such as telemedicine consultation. Conclusions: Overall, prescribing providers in WA reported ongoing concerns regarding opioid use for CNCP, but those affiliated with a health care organization with opioid prescribing guidelines and access to pain consultation were less likely to report being concerned about opioid-related problems or to have discontinued prescribing opioids. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Drug Therapy Health Personnel Occupational Health Safety
• Keywords:
  Author Keywords: Chronic Pain Drug Therapy Health Care Workers Medical Care Medical Surveys Nurse Practitioners Opioids Physicians Prescription Drugs Primary Health Care
• ISSN:
  1557-2625
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 10 ; OSHA Region 5 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  394-400
• Volume:
  26
• Issue:
  4
• NIOSHTIC Number:
  nn:20056420
• Citation:
  J Am Board Fam Med 2013 Jul; 26(4):394-400
• Contact Point Address:
  Gary M. Franklin, MD, MPH, 130 Nickerson, Suite 212, Seattle, WA 98109
• Email:
  meddir@uw.edu
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of the American Board of Family Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d1a7f8d41b70691874070bac6bddfd5ae415a13a9a425dd2274f7579a80902ed20a8a1c2ce816a46462fa3a3bcc8566cecf4ed1b96cb45511b1ba191784b46c1
• Download URL:
  https://stacks.cdc.gov/view/cdc/214028/cdc_214028_DS1.pdf
• File Type:
  [PDF - 86.07 KB ]