Online Program

Opioid pain relievers: A qualitative exploration of physician perspectives on prescribing and patient education in two emergency departments

Monday, November 2, 2015

Nicholas Rizzutti, MSW, Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Andrea Gielen, ScD, ScM, Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Shannon Frattaroli, MPH, PhD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
background/purpose: Prescription opioid pain reliever (OPR) misuse and abuse is a growing public health problem resulting in significant morbidity and mortality. Emergency departments (EDs) are one source of OPRs that are misused/abused. In the United States, opioid prescribing in EDs has increased by 60% between 1993 and 2005 . The present research further investigates how ED physicians think about OPR prescribing, how the ED can be used as a setting for prevention interventions generally, and mobile health interventions in particular.

methods:  We developed a qualitative interview guide and interviewed 12 ED physicians. Based on the findings, we developed a coding dictionary and data were coded. Thematic analyses were then performed using the coded data.

results/outcomes : All interviewees agreed that better patient education on pain management is needed, and that the ED setting is a viable venue for such efforts. Interviewees were unable to identify a standardized set of protocols for prescribing OPRs within their own EDs. No providers reported routinely talking with patients about proper storage and disposal of OPRs. Many interviewees connected patient satisfaction scores with prescribing practices. Some physicians conveyed their struggle to ensure that patients have realistic expectations of pain relief. All interviewees supported the idea of using mobile health technology in the ED to educate patients, but stressed that it should only be used as a complement to doctor-patient communication.

conclusions: Patient education on risks/benefits, proper storage/disposal/safe use, as well as alternatives to OPRs is needed to help ED patients make informed decisions about their pain management.

Learning Areas:

Assessment of individual and community needs for health education
Clinical medicine applied in public health
Public health or related research

Learning Objectives:
Identify three common themes that emerged from qualitative interviews with emergency department physicians. Identify opportunities to develop and strengthen current protocols for prescribing opioid pain relievers in an emergency department setting.

Keyword(s): Prescription Drug Abuse and Misuse, Physicians

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior research program coordinator and qualitative investigator at the Johns Hopkins Center For Injury Research and Policy. I received a Masters in Social Work in 2013 with a emphasis in Health from University of Maryland, Baltimore. I have worked on multiple federally funded projects focusing on unintentional injury prevention in emergency department settings including child passenger safety, fire prevention and prescription drug overdose prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.