Evidence map›Paper›PMID 40897972›Full record

ArticleJournal of general internal medicine2026

"I Am Reluctant to Continue, Yet Know She Could Go into Withdrawal": A Qualitative Analysis of Clinician Requests for eConsults in Opioid Management in the Ambulatory Setting.

Laila Khalid, Sharon Rikin, Dana Watnick, Tiffany Y Lu, Gianni Carrozzi, Ana Valle, Joanna L Starrels

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

7 authors.

Laila KhalidMontefiore Medical Center, Bronx, NY, USA. lkhalid@montefiore.org.ORCID 0000-0002-0169-5778
Sharon RikinMontefiore Medical Center, Bronx, NY, USA.
Dana WatnickMontefiore Medical Center, Bronx, NY, USA.
Tiffany Y LuAlbert Einstein College of Medicine, Bronx, NY, USA.
Gianni CarrozziMontefiore Medical Center, Bronx, NY, USA.
Ana ValleBrigham and Women's Hospital, Boston, MA, USA.
Joanna L StarrelsMontefiore Medical Center, Bronx, NY, USA.

Funding

Integrated Care for Chronic Pain and Opioid Use Disorder: The IMPOWR Research Center at Montefiore/Einstein (IMPOWR-ME)RM1DA055437 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI ARNSTEN, JULIA H., GABBAY, VILMA · 2021 to 2025
$13.7M
Mentoring Junior Investigators to Tackle the Opioid EpidemicK24DA046309 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI STARRELS, JOANNA L. · 2018 to 2023
$876k
Foundation for the National Institutes of Health RM1DA055437National Institute of Development Administration K24DA046309NIDA NIH HHS K24 DA046309NIDA NIH HHS RM1 DA055437
6 · The paper itself

Abstract

backgroundElectronic consultations (eConsults) allow clinicians to submit questions through the electronic health records (EHR) to request specialist input about individual patients' care, but there is paucity of literature describing eConsult programs specifically for opioid management.

objectives1. To understand clinicians' reasons for seeking eConsults for opioid management. 2. To describe characteristics of clinicians' questions that can be addressed through eConsults without requiring in-person specialist visits.

designRetrospective qualitative study of eConsults for opioid management in the ambulatory setting.

participantsClinicians who submitted an eConsult request for opioid management. APPROACH: We conducted a qualitative content analysis of eConsult requests and responses. First, a priori codes were developed and applied to textual data. Through iterative discussion and memoing, thematic codes were identified and applied to the dataset. Subsequently, breadth and depth of codes were explored, collapsed, and redefined, and relationships between codes were discussed. Following theme development, matrix analysis was used to compare eConsults that resulted with or without a recommendation for an in-person specialist visit. KEY

resultsForty eConsults were requested by 30 unique referring clinicians mostly from general internal medicine (53%) or family medicine (27%). We identified four themes: (1) clinicians were motivated to reduce harm, (2) clinicians had difficulty labeling opioid misuse and use disorder (OUD), (3) clinicians had difficulty articulating discrete questions, and (4) clinician questions revealed knowledge gaps in opioid management. In-person specialist visits were recommended when clinicians needed help with labeling opioid misuse or OUD or when questions were vague and around complex topics.

conclusionClinicians have unease and discomfort in treating chronic pain and managing opioids. eConsults are most helpful for low-complexity, discrete questions from clinicians focused on reducing harm. eConsult implementation should integrate EHR enhancements and clinician training in assessing opioid misuse and OUD and articulating discrete questions.

Indexed as

Ambulatory CareAnalgesics, OpioidAdultAttitude of Health PersonnelElectronic Health RecordsFemaleHumansMaleMiddle AgedOpioid-Related DisordersQualitative ResearchRetrospective StudiesAnalgesics, OpioideConsultsopioid managementoutpatientqualitative analysis

Identifiers

PMID40897972
PMCPMC13009407

What OpenQuestion holds

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LicenceCC BY
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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.