Nicholas E Hagemeier1, Fred Tudiver2, Scott Brewster3, Elizabeth J Hagy3, Brittany Ratliff3, Angela Hagaman4, Robert P Pack5. 1. a Department of Pharmacy Practice , East Tennessee State University Gatton College of Pharmacy , Johnson City , Tennessee , USA. 2. b Department of Family Medicine , East Tennessee State University Quillen College of Medicine , Johnson City , Tennessee , USA. 3. c Department of Pharmacy Practice , East Tennessee State University Gatton College of Pharmacy , Johnson City , Tennessee , USA. 4. d Department of Community and Behavioral Health , East Tennessee State University College of Public Health , Johnson City , Tennessee , USA. 5. e Department of Community and Behavioral Health , East Tennessee State University College of Public Health , Johnson City , Tennessee , USA.
Abstract
BACKGROUND: Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed support for interventions that improve interprofessional communication and reduce prescription opioid abuse. The objective of this study was to describe prescription opioid abuse-related communication among and between prescribers and community pharmacists in South Central Appalachia. METHODS: The investigators conducted five focus groups with 35 Appalachian Research Network practice-based research network providers between February and October, 2014. Two prescriber-specific, two pharmacist-specific, and one interprofessional (prescribers and pharmacists) focus groups were conducted, recorded, and transcribed. Data collection and analysis occurred iteratively. Emerging themes were inductively derived and refined. Five member-checking interviews were conducted to validate themes. RESULTS: Providers noted several factors that influence intraprofessional and interprofessional communication, including level of trust, role perceptions, conflict history and avoidance, personal relationships, and prescription monitoring program use. Indirect communication approaches via patients, office staff, and voicemail systems were common. Direct pharmacist to prescriber and prescriber to pharmacist communication was described as rare and often perceived to be ineffective. Prescriber to pharmacist communication was reported by prescribers to have decreased after implementation of state prescription monitoring programs. Difficult or uncomfortable conversations were often avoided by providers. CONCLUSIONS: Interprofessional and intraprofessional prescription opioid abuse communication is situational and influenced by multiple factors. Indirect communication and communication avoidance are common. Themes identified in this study can inform development of interventions that improve providers' intra- and interprofessional communication skills.
BACKGROUND: Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed support for interventions that improve interprofessional communication and reduce prescription opioid abuse. The objective of this study was to describe prescription opioid abuse-related communication among and between prescribers and community pharmacists in South Central Appalachia. METHODS: The investigators conducted five focus groups with 35 Appalachian Research Network practice-based research network providers between February and October, 2014. Two prescriber-specific, two pharmacist-specific, and one interprofessional (prescribers and pharmacists) focus groups were conducted, recorded, and transcribed. Data collection and analysis occurred iteratively. Emerging themes were inductively derived and refined. Five member-checking interviews were conducted to validate themes. RESULTS: Providers noted several factors that influence intraprofessional and interprofessional communication, including level of trust, role perceptions, conflict history and avoidance, personal relationships, and prescription monitoring program use. Indirect communication approaches via patients, office staff, and voicemail systems were common. Direct pharmacist to prescriber and prescriber to pharmacist communication was described as rare and often perceived to be ineffective. Prescriber to pharmacist communication was reported by prescribers to have decreased after implementation of state prescription monitoring programs. Difficult or uncomfortable conversations were often avoided by providers. CONCLUSIONS: Interprofessional and intraprofessional prescription opioid abuse communication is situational and influenced by multiple factors. Indirect communication and communication avoidance are common. Themes identified in this study can inform development of interventions that improve providers' intra- and interprofessional communication skills.
Authors: Catherine S Hwang; Lydia W Turner; Stefan P Kruszewski; Andrew Kolodny; G Caleb Alexander Journal: JAMA Intern Med Date: 2015-02 Impact factor: 21.873
Authors: Catherine S Hwang; Lydia W Turner; Stefan P Kruszewski; Andrew Kolodny; G Caleb Alexander Journal: Clin J Pain Date: 2016-04 Impact factor: 3.442
Authors: Margie E Snyder; Alan J Zillich; Brian A Primack; Kristen R Rice; Melissa A Somma McGivney; Janice L Pringle; Randall B Smith Journal: Res Social Adm Pharm Date: 2010-02-11
Authors: Marc L Fleming; Jamie C Barner; Carolyn M Brown; Marv D Shepherd; Scott A Strassels; Suzanne Novak Journal: J Am Pharm Assoc (2003) Date: 2014 May-Jun
Authors: Nicholas E Hagemeier; Fred Tudiver; Scott Brewster; Elizabeth J Hagy; Angela Hagaman; Robert P Pack Journal: Res Social Adm Pharm Date: 2015-12-29
Authors: Aaron Salwan; Nicholas E Hagemeier; Fred Tudiver; KariLynn Dowling-McClay; Kelly N Foster; Jessie Arnold; Arsham Alamian; Robert P Pack Journal: J Am Pharm Assoc (2003) Date: 2020-07-12
Authors: Daniel J Ventricelli; Stephanie M Mathis; Kelly N Foster; Robert P Pack; Fred Tudiver; Nicholas E Hagemeier Journal: Subst Use Misuse Date: 2019-10-08 Impact factor: 2.164