Jonathan Penm1, Neil J MacKinnon2, Chloe Connelly2, Rebecca Mashni3, Michael S Lyons4, Edmond A Hooker4, Erin L Winstanley5, Steve Carlton-Ford6, Erica Tolle2, Jill Boone2, Kathleen Koechlin7, Jolene Defiore-Hyrmer7. 1. The University of Sydney School of Pharmacy, Camperdown, New South Wales, Australia. 2. James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio. 3. Boston University Law School, Boston, Massachusetts. 4. Department of Emergency Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio. 5. Department of Behavioral Medicine & Psychiatry, School of Medicine, West Virginia University, Morgantown, West Virginia. 6. McMicken College of Arts and Science, University of Cincinnati, Cincinnati, Ohio. 7. Ohio Department of Health, Columbus, Ohio.
Abstract
BACKGROUND: Ohio has the fifth highest rate of prescription opioid overdose deaths in the United States. One strategy implemented to address this concern is a state-wide opioid prescribing guideline in the emergency department (ED). OBJECTIVE: Our aim was to explore emergency physicians' perceptions on barriers and strategies for the Ohio ED opioid prescribing guideline. METHODS: Semi-structured interviews with emergency physicians in Ohio were conducted from October to December 2016. Emergency physicians were recruited through the American College of Emergency Physicians Ohio State Chapter. The interview guide explored issues related to the implementation of the guidelines. Interview data were transcribed and thematically analyzed and coded using a scheme of inductively determined labels. RESULTS: In total, we conducted 20 interviews. Of these, 11 were also the ED medical director at their institution. Main themes we identified were: 1) increased organizational responsibility, 2) improved prescription drug monitoring program (PDMP) integration, 3) concerns regarding patient satisfaction scores, and 4) increased patient involvement. In addition, some physicians wanted the guidelines to contain more clinical information and be worded more strongly against opioid prescribing. Emergency physicians felt patient satisfaction scores were perceived to negatively impact opioid prescribing guidelines, as they may encourage physicians to prescribe opioids. Furthermore, some participants reported that this is compounded if the emergency physicians' income was linked to their patient satisfaction score. CONCLUSIONS: Emergency physicians interviewed generally supported the state-wide opioid prescribing guideline but felt hospitals needed to take additional organizational responsibility for addressing inappropriate opioid prescribing.
BACKGROUND: Ohio has the fifth highest rate of prescription opioid overdose deaths in the United States. One strategy implemented to address this concern is a state-wide opioid prescribing guideline in the emergency department (ED). OBJECTIVE: Our aim was to explore emergency physicians' perceptions on barriers and strategies for the Ohio ED opioid prescribing guideline. METHODS: Semi-structured interviews with emergency physicians in Ohio were conducted from October to December 2016. Emergency physicians were recruited through the American College of Emergency Physicians Ohio State Chapter. The interview guide explored issues related to the implementation of the guidelines. Interview data were transcribed and thematically analyzed and coded using a scheme of inductively determined labels. RESULTS: In total, we conducted 20 interviews. Of these, 11 were also the ED medical director at their institution. Main themes we identified were: 1) increased organizational responsibility, 2) improved prescription drug monitoring program (PDMP) integration, 3) concerns regarding patient satisfaction scores, and 4) increased patient involvement. In addition, some physicians wanted the guidelines to contain more clinical information and be worded more strongly against opioid prescribing. Emergency physicians felt patient satisfaction scores were perceived to negatively impact opioid prescribing guidelines, as they may encourage physicians to prescribe opioids. Furthermore, some participants reported that this is compounded if the emergency physicians' income was linked to their patient satisfaction score. CONCLUSIONS: Emergency physicians interviewed generally supported the state-wide opioid prescribing guideline but felt hospitals needed to take additional organizational responsibility for addressing inappropriate opioid prescribing.
Authors: Stephen V Cantrill; Michael D Brown; Russell J Carlisle; Kathleen A Delaney; Daniel P Hays; Lewis S Nelson; Robert E O'Connor; Annmarie Papa; Karl A Sporer; Knox H Todd; Rhonda R Whitson Journal: Ann Emerg Med Date: 2012-10 Impact factor: 5.721
Authors: Laura J Damschroder; David C Aron; Rosalind E Keith; Susan R Kirsh; Jeffery A Alexander; Julie C Lowery Journal: Implement Sci Date: 2009-08-07 Impact factor: 7.327
Authors: Donna M Zulman; Laura J Damschroder; Ryan G Smith; Paul J Resnick; Ananda Sen; Erin L Krupka; Caroline R Richardson Journal: Transl Behav Med Date: 2013-12 Impact factor: 3.046
Authors: Austin S Kilaru; Sarah M Gadsden; Jeanmarie Perrone; Breah Paciotti; Frances K Barg; Zachary F Meisel Journal: Ann Emerg Med Date: 2014-04-16 Impact factor: 5.721
Authors: Francesca L Beaudoin; Steven Straube; Jason Lopez; Michael J Mello; Janette Baird Journal: Am J Emerg Med Date: 2014-02-26 Impact factor: 2.469
Authors: Carla A Green; Dennis McCarty; Jennifer Mertens; Frances L Lynch; Anadam Hilde; Alison Firemark; Constance M Weisner; David Pating; Bradley M Anderson Journal: J Subst Abuse Treat Date: 2013-10-23
Authors: Bory Kea; Tahroma Alligood; Cassandra Robinson; Josephine Livingston; Benjamin C Sun Journal: Ann Emerg Med Date: 2019-05-09 Impact factor: 5.721
Authors: Daniel M Walker; Janet E Childerhose; Sadie Chen; Nicolette Coovert; Rebecca D Jackson; Natasha Kurien; Ann Scheck McAlearney; Jaclyn Volney; Daniel P Alford; Julie Bosak; Douglas R Oyler; Laura K Stinson; Melika Behrooz; Mia-Cara Christopher; Mari-Lynn Drainoni Journal: Drug Alcohol Depend Date: 2022-02-02 Impact factor: 4.492