Daniel M Walker1, Janet E Childerhose2, Sadie Chen3, Nicolette Coovert3, Rebecca D Jackson4, Natasha Kurien3, Ann Scheck McAlearney5, Jaclyn Volney3, Daniel P Alford6, Julie Bosak7, Douglas R Oyler8, Laura K Stinson9, Melika Behrooz10, Mia-Cara Christopher10, Mari-Lynn Drainoni11. 1. Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Road, Suite 4000, Columbus, OH 43202, USA; CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 700 Ackerman Road, Suite 4000, Columbus, OH 43202, USA. Electronic address: Daniel.Walker@osumc.edu. 2. CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 700 Ackerman Road, Suite 4000, Columbus, OH 43202, USA; Department of Internal Medicine, College of Medicine, The Ohio State University, Martha Morehouse Pavilion, 2050 Kenny Road, Suite 2428, Columbus, OH 43221, USA. 3. CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 700 Ackerman Road, Suite 4000, Columbus, OH 43202, USA. 4. Center for Clinical and Translational Science and the Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, The Ohio State University, 376 W. 10th Ave, Suite 205, Columbus, OH 43210, USA. 5. Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Road, Suite 4000, Columbus, OH 43202, USA; CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 700 Ackerman Road, Suite 4000, Columbus, OH 43202, USA. 6. Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Ave, Rm 2060, Boston, MA 02118, USA. 7. Boston Medical Center, 801 Massachusetts Ave, Boston, MA 02118, USA. 8. Pharmacy Practice and Science Department, College of Pharmacy, University of Kentucky, 760 Press Ave, Lexington, KY 40536, USA. 9. Substance Use Priority Research Area, University of Kentucky, 760 Press Avenue, Suite 270, Lexington, KY 40536, USA. 10. Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Ave, New York, NY 10027, USA. 11. Boston University School of Medicine, 801 Massachusetts Ave, Boston, MA 02118, USA.
Abstract
BACKGROUND: Community-based perspectives are needed to more broadly inform policy-makers, public health practitioners, prescribers, and pharmacists about community-led and broader efforts to reduce opioid overprescribing, and ultimately reduce prescription opioid use disorder, overdoses and fatalities. The aim of this study is to explore community-based perspectives on efforts to change opioid prescribing practices in their communities. METHODS: Semi-structured interviews were conducted with 388 community stakeholders across four states (Kentucky, Massachusetts, New York, Ohio) from November 2019 to January 2020 about community approaches and goals of community-led responses to the opioid crisis. Data analysis combined deductive and inductive approaches to identify themes and sub-themes related to improving opioid prescribing practices. RESULTS: Three major themes and different subthemes were characterized: (1) acknowledging progress (i.e., healthcare providers being part of the solution, provider education, and prescription drug monitoring programs); (2) emergent challenges (i.e., physician nonadherence with safer opioid prescribing guidelines, difficulty identifying appropriate use of opioids, and concerns about accelerating the progression from opioid misuse to drug abuse); and (3) opportunities for change (i.e., educating patients about safer use and proper disposal of opioids, expanding prescriber and pharmacist education, changing unrealistic expectations around eliminating pain, expanding and increasing insurance coverage for alternative treatment options). CONCLUSIONS: Community stakeholders appeared to support specific opportunities to reduce prescription opioid misuse and improve safer prescribing. The opportunities included culture change around pain expectations, awareness of safe disposal, additional provider education, and increased coverage and acceptability of non-opioid treatments.
BACKGROUND: Community-based perspectives are needed to more broadly inform policy-makers, public health practitioners, prescribers, and pharmacists about community-led and broader efforts to reduce opioid overprescribing, and ultimately reduce prescription opioid use disorder, overdoses and fatalities. The aim of this study is to explore community-based perspectives on efforts to change opioid prescribing practices in their communities. METHODS: Semi-structured interviews were conducted with 388 community stakeholders across four states (Kentucky, Massachusetts, New York, Ohio) from November 2019 to January 2020 about community approaches and goals of community-led responses to the opioid crisis. Data analysis combined deductive and inductive approaches to identify themes and sub-themes related to improving opioid prescribing practices. RESULTS: Three major themes and different subthemes were characterized: (1) acknowledging progress (i.e., healthcare providers being part of the solution, provider education, and prescription drug monitoring programs); (2) emergent challenges (i.e., physician nonadherence with safer opioid prescribing guidelines, difficulty identifying appropriate use of opioids, and concerns about accelerating the progression from opioid misuse to drug abuse); and (3) opportunities for change (i.e., educating patients about safer use and proper disposal of opioids, expanding prescriber and pharmacist education, changing unrealistic expectations around eliminating pain, expanding and increasing insurance coverage for alternative treatment options). CONCLUSIONS: Community stakeholders appeared to support specific opportunities to reduce prescription opioid misuse and improve safer prescribing. The opportunities included culture change around pain expectations, awareness of safe disposal, additional provider education, and increased coverage and acceptability of non-opioid treatments.
Authors: Karen Denyer; Helen Smith; Kevin Davies; Rob Horne; Matthew Hankins; Karen Walker-Bone Journal: Complement Ther Med Date: 2011-11-29 Impact factor: 2.446
Authors: Megan E Gregory; Daniel M Walker; Lindsey N Sova; Sheryl A Pfeil; Clayton D Rothwell; Jaclyn J Volney; Alice A Gaughan; Ann Scheck McAlearney Journal: Adv Health Care Manag Date: 2021-12-06
Authors: Barbara Andraka-Christou; Joshua B Rager; Brittany Brown-Podgorski; Ross D Silverman; Dennis P Watson Journal: Subst Abuse Treat Prev Policy Date: 2018-05-22
Authors: Elizabeth C Danielson; Christopher A Harle; Ross Silverman; Justin Blackburn; Nir Menachemi Journal: Pain Med Date: 2021-12-11 Impact factor: 3.750
Authors: Hannah K Knudsen; Mari-Lynn Drainoni; Louisa Gilbert; Timothy R Huerta; Carrie B Oser; Alison M Aldrich; Aimee N C Campbell; Erika L Crable; Bryan R Garner; LaShawn M Glasgow; Dawn Goddard-Eckrich; Katherine R Marks; Ann Scheck McAlearney; Emmanuel A Oga; Ariel L Scalise; Daniel M Walker Journal: Drug Alcohol Depend Date: 2020-10-02 Impact factor: 4.492