Clinicians' Attitudes and Beliefs About Opioids Survey (CAOS): Instrument Development and Results of a National Physician Survey

Wilson, Hilary; Dansie, Elizabeth J.; Kim, Myoung S.; Moskovitz, Bruce L.; Chow, Wing; Turk, Dennis C.

doi:10.1016/j.jpain.2013.01.769

Cited by 37 publications

(35 citation statements)

References 20 publications

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“…Across specialties, physicians believe that opioid pain medication can be effective in controlling pain, that addiction is a common consequence of prolonged use, and that long-term opioid therapy often is overprescribed for patients with chronic noncancer pain (27). These attitudes and beliefs, combined with increasing trends in opioid-related overdose, underscore the need for better clinician guidance on opioid prescribing.…”

Section: Rationalementioning

confidence: 99%

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Haegerich²,

2016

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Section: Rationalementioning

confidence: 99%

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Haegerich²,

2016

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“…Previous studies have shown that physicians' negative attitudes about opioids influences prescribing. 22 A limitation of this study was the modest response rate. About half of residency directors chose not to respond to the survey.…”

Section: Discussionmentioning

confidence: 90%

Teaching Chronic Pain in the Family Medicine Residency

Zoberi

Everard

2018

Fam Med

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Background and Objectives: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. Methods: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors’ attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring). Attitudes were assessed by asking whether: (1) chronic pain is best managed by a primary care physician (PCP); (2) prescribing opioid medications is time consuming; (3) prescribing opioids is high-risk; (4) prescribing opioids contributes to opioid misuse; and (4) effective nonopioid treatments exist. An additional question assessed confidence in treating chronic pain. Results: The response rate was 53%. The average family medicine residency devotes about 33 hours to education about pain management topics including 5.4 hours on chronic pain assessment, 16.2 hours on therapy, and 11.4 hours on risk assessment. Residency directors’ belief that there are effective nonopioid treatments for chronic pain was the only attitude item that was associated with teaching about chronic pain. Conclusions: Residency directors’ attitudes do not predict the time devoted to teaching chronic pain in family medicine residencies.

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“…Thus, the findings raise interesting questions about clinical decision making surrounding this issue. 18 For example, in a recent study of physicians' prescribing practices, both lack of knowledge and fear of causing harm were identified by health care clinicians as barriers to recommending patient use of opioids. 19,20 This can be particularly true in the older Journal of Hospice & Palliative Nursing www.jhpn.com adult population, in which there is a fear of using opioid medications in general because of their negative effects in the elderly.…”

Section: Discussionmentioning

confidence: 99%