Evidence map›Paper›PMID 34904698›Full record

ArticleJournal of opioid management

How opioid prescribing policies influence primary care clinicians' treatment decisions and conversations with patients with chronic pain.

Elizabeth C Danielson, Christopher A Harle, Sarah M Downs, Laura Militello, Olena Mazurenko

Open access · greenAbstract read
In one paragraph

Article in Journal of opioid management. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 1 country.

Elizabeth C DanielsonPostdoctoral Fellow, Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois. ORCID: https://orcid.org/0000-0003-2792-7140.
Christopher A HarleProfessor, Department of Health Outcomes and Biomedical Informatics, Chief Research Information Officer, University of Florida Health, Gainesville, Florida.
Sarah M DownsResearch Program Coordinator, Indiana University School of Medicine, Indianapolis, Indiana.
Laura MilitelloSenior Scientist, Applied Decision Science, LLC, Cincinnati, Ohio.
Olena MazurenkoAssociate Professor, Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana; Affiliated Scientist, Regenstrief Institute, Indianapolis, Indiana.
Applied Decision Science (United States) · USIndiana University – Purdue University Indianapolis · USNorthwestern University · USRegenstrief Institute · USUniversity of Florida Health · US

Funding

AHRQ HHS R01 HS023306
6 · The paper itself

Abstract

objectiveThe 2016 Centers for Disease Control and Prevention guideline for prescribing opioids for chronic pain aimed to assist primary care clinicians in safely and effectively prescribing opioids for chronic noncancer pain. Individual states, payers, and health systems issued similar policies imposing various regulations around opioid prescribing for patients with chronic pain. Experts argued that healthcare organizations and clinicians may be misapplying the federal guideline and subsequent opioid prescribing policies, leading to an inadequate pain management. The objective of this study was to understand how primary care clinicians involve opioid prescribing policies in their treatment decisions and in their conversations with patients with chronic pain.

designWe conducted a secondary qualitative analysis of data from 64 unique primary care visits and 87 post-visit interviews across 20 clinicians from three healthcare systems in the Midwestern United States. Using a multistep process and thematic analysis, we systematically analyzed data excerpts addressing opioid prescribing policies.

resultsOpioid prescribing policies influenced clinicians' treatment decisions to not initiate opioids, prescribe fewer opioids overall (theme #1), and begin tapering and discontinuation of opioids (theme #2) for most patients with chronic pain. Clinical precautions, described in the opioid prescribing policies to monitor use, were directly invoked during visits for patients with chronic pain (theme #3).

conclusionsOpioid prescribing policies have multidimensional influence on clinician treatment decisions for patients with chronic pain. Our findings may inform future studies to explore mechanisms for aligning pressures around opioid prescribing, stemming from various opioid prescribing policies, with the need to deliver individualized pain care.

Indexed as

Analgesics, OpioidChronic PainHumansPolicyPractice Patterns, Physicians'Primary Health CareAnalgesics, Opioid

Identifiers

PMID34904698
PMCPMC9347324
OpenAlexW4200615381

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.