June 25, 2013 According to a study of physicians' attitudes about pain drugs published in The Journal of Pain, negative physician attitudes about opioid medications are closely associated with lower rates of prescribing and more favorable attitudes are linked with higher prescribing levels.
The Journal of Pain is the peer review publication of the American Pain Society.
In 1994, Dennis C. Turk, PhD and colleagues at the University of Washington conducted a survey of physician attitudes about prescribing opioids for chronic non-cancer pain, which identified significant differences in attitudes and beliefs throughout the country and by medical specialty. The current study, also conducted by University of Washington researchers and collaborators, was intended to assess how physician beliefs about opioids have evolved over time and may coincide with changes in regulations, increasing drug misuse and negative public opinions about narcotic pain medications.
A 38-item questionnaire probed attitudes on impediments and concerns regarding opioid prescribing, perceived efficacy, medical education, and benefits of tamper resistant formulations (TRFs). Phases Two and Three involved pilot testing and the formal survey of 1,535 physicians.
More than 70 percent of the respondents reported they use opioids in fewer than 30 percent of their patients with chronic non-cancer pain. However, physicians who see higher volumes of pain patients were more likely to prescribe opioids and said they are less concerned with impediments surrounding opioids, are not worried about or avoidant of prescribing Schedule II vs. Schedule III drugs, believe in the benefits of TRFs, and know they were adequately trained to treat chronic pain. These results are consistent with other studies showing that physician uneasiness with prescribing long-term opioids is linked with inexperience in using the medications.
There were no differences shown in overall physician attitudes about opioids in various areas of the country. The authors noted that orthopedists expressed the most negative views of opioids, showed the lowest level of confidence in drug efficacy, and had the highest mean levels of concern about opioid addiction, tolerance and dependence.
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- Hilary D. Wilson, Elizabeth J. Dansie, Myoung S. Kim, Bruce L. Moskovitz, Wing Chow, Dennis C. Turk. Clinicians' Attitudes and Beliefs About Opioids Survey (CAOS): Instrument Development and Results of a National Physician Survey. The Journal of Pain, 2013; 14 (6): 613 DOI: 10.1016/j.jpain.2013.01.769
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