A Perelló Bratescu1, B Adriyanov2, C Dürsteler3, A Sisó-Almirall2, M A Álvarez Carrera4, N Riera Nadal5. 1. Centre d'Atenció Primària Larrard, Barcelona, España; Atenció Primària Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Investigación Transversal en Atención Primaria, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España. Electronic address: aperebrat@hotmail.com. 2. Grupo de Investigación Transversal en Atención Primaria, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, España. 3. Unidad del Dolor, Hospital Clínic, Barcelona, España. 4. Atenció Primària Parc Sanitari Pere Virgili, Barcelona, España. 5. Centre d'Atenció Primària Sagrada Família, Consorci Sanitari Integral. Barcelona, España.
Abstract
OBJECTIVE: To identify family doctor prescription patterns for strong opioids for chronic, non-cancer-related pain. MATERIALS AND METHODS: Design A descriptive study based on a self-administered email questionnaire. LOCATION: All primary health care centres in Catalonia. PARTICIPANTS: 3,602 family doctors, all members of the Catalan Society of Family and Community Medicine. INTERVENTIONS: Email survey of Catalan family doctors. MAIN MEASUREMENTS: Demographic data, number of patients treated with potent opioids for chronic non-cancer pain, type of opioid used and indications, prescribing patterns and relationship with the Pain Management Unit. RESULTS: A total of 551 answers were obtained from 3,602 questionnaires sent (response rate of 15.3%), in which 480 physicians (87%) prescribed strong opioids for musculoskeletal pain, 268 (48.6%) prescribed ultra-rapid fentanyl and 434 (78.7%) reduced benzodiazepines dosage when prescribing potent opioids. The most common adverse effects were constipation and nausea. The main problems related with opioid prescription were improper use (341, 71%) and patient and/or practitioner reluctance (87, 18.1%). The assessment of the relationship with Pain Management Units was 2±1 (on a 1 to 5 scale), with communication (271, 52.2%) and accessibility (141, 27.1%) being the areas most in need of improvement. CONCLUSIONS: Opioid prescribing patterns generally follow clinical guidelines (e.g. reduction of benzodiazepine use or dose titration). However, there are some areas of improvement, such as sparse use of laxatives or use of ultra-rapid opioids for unapproved indications and in patients with no background opioid therapy. Family doctors perceive patient reluctance to adhere to the prescribed treatment, and call for specific training and better relationships with Pain Management Units.
OBJECTIVE: To identify family doctor prescription patterns for strong opioids for chronic, non-cancer-related pain. MATERIALS AND METHODS: Design A descriptive study based on a self-administered email questionnaire. LOCATION: All primary health care centres in Catalonia. PARTICIPANTS: 3,602 family doctors, all members of the Catalan Society of Family and Community Medicine. INTERVENTIONS: Email survey of Catalan family doctors. MAIN MEASUREMENTS: Demographic data, number of patients treated with potent opioids for chronic non-cancer pain, type of opioid used and indications, prescribing patterns and relationship with the Pain Management Unit. RESULTS: A total of 551 answers were obtained from 3,602 questionnaires sent (response rate of 15.3%), in which 480 physicians (87%) prescribed strong opioids for musculoskeletal pain, 268 (48.6%) prescribed ultra-rapid fentanyl and 434 (78.7%) reduced benzodiazepines dosage when prescribing potent opioids. The most common adverse effects were constipation and nausea. The main problems related with opioid prescription were improper use (341, 71%) and patient and/or practitioner reluctance (87, 18.1%). The assessment of the relationship with Pain Management Units was 2±1 (on a 1 to 5 scale), with communication (271, 52.2%) and accessibility (141, 27.1%) being the areas most in need of improvement. CONCLUSIONS: Opioid prescribing patterns generally follow clinical guidelines (e.g. reduction of benzodiazepine use or dose titration). However, there are some areas of improvement, such as sparse use of laxatives or use of ultra-rapid opioids for unapproved indications and in patients with no background opioid therapy. Family doctors perceive patient reluctance to adhere to the prescribed treatment, and call for specific training and better relationships with Pain Management Units.
Keywords:
Analgésicos opioides; Chronic pain; Dolor crónico; Encuestas y cuestionarios; Médicos de Atención Primaria; Opioid analgesics; Opioid-related disorders; Pautas de la práctica en medicina; Physicians practice patterns; Primary Care physicians; Surveys and questionnaires; Trastornos relacionados con opioides
Authors: Aina Perelló-Bratescu; Christian Dürsteler; Maria Asunción Álvarez-Carrera; Laura Granés; Belchin Kostov; Antoni Sisó-Almirall Journal: Pharmaceutics Date: 2022-01-20 Impact factor: 6.321
Authors: Aina Perelló-Bratescu; Christian Dürsteler; Maria Asunción Álvarez-Carrera; Laura Granés; Belchin Kostov; Antoni Sisó-Almirall Journal: Int J Environ Res Public Health Date: 2022-01-31 Impact factor: 3.390