Understanding provider prescription practices for opioids in the surgical patient

Update item information
Publication Type dissertation
School or College School of Medicine
Department Family and Preventive Medicine
Author Thiesset, Heather Freckleton Gagon
Title Understanding provider prescription practices for opioids in the surgical patient
Date 2019
Description In light of the growing opioid epidemic, reducing the overprescription of opioids has been targeted as one method to minimize opioid diversion, prompting several groups to publish guidelines for providers including the Centers for Disease Control and Prevention (CDC). Adoption and compliance with these guidelines requires buy-in from providers. However, little is known about the attitudes, perceptions, and practices of surgical providers regarding opioid stewardship. We developed a 35-item prescribing provider survey to measure the attitudes, perceptions, and practices of providers in the Department of Surgery at the University of Utah regarding opioid prescribing. The survey was developed to understand how demographic factors of providers affect opioid prescribing practices and to understand provider attitudes and perceptions regarding opioid prescribing. The survey was distributed to providers in a multidisciplinary surgical department at a single tertiary academic medical center. Demographic characteristics were generated comparing surgeons to resident and advanced practice clinicians (APCs). Additionally, we assessed attitudes, perceptions, and practices of surgical providers with CDC best practices in regards to opioid prescriptions. In order to assess provider screening practices of opioid misuse before surgery, we reviewed a random sample of electronic medical records (EMRs) from 100 patients. These patients had previously participated in a separate patient pain management survey during their postoperative clinic follow-up appointments as part of an ongoing pain management study. Data from the chart review and survey were compared to understand opioid misuse screening rates in surgical patients, and if individual provider or patient variables affected whether patients were screened before surgery. Our analysis showed that a wide variation in opioid prescribing attitudes, perceptions, and practices exist among surgical providers. Despite previously reported evidence suggesting that surgical providers are overprescribing opioids, which can lead to leftover opioids being used for recreation, providers often feel that they do not have the time nor hold primary responsibility for opioid stewardship. Furthermore, our study showed that there is a lack of provider documentation as to whether patients in the presurgical setting are being screened for opioid misuse. Further research is needed to develop and implement effective interventions for opioid stewardship in the surgical environment.
Type Text
Publisher University of Utah
Dissertation Name Doctor of Philosophy
Language eng
Rights Management (c) Heather Freckleton Gagon Thiesset
Format Medium application/pdf
ARK ark:/87278/s6771gmb
Setname ir_etd
Date Created 2021-09-13
Date Modified 2021-09-14
ID 1714356
Reference URL https://collections.lib.utah.edu/ark:/87278/s6771gmb
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