Veterans affairs primary care clinicians' attitudes toward chronic pain and correlates of opioid prescribing rates

Steven Dobscha, Kathryn Corson, Jennifer A. Flores, Erin C. Tansill, Martha S. Gerrity

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Objectives. The primary objective of this study was to identify veterans affairs (VA) primary care clinicians' attitudes regarding chronic pain treatment. A secondary objective was to explore relationships between clinician and practice characteristics and an objective measure of opioid prescribing rates. Design. Cross-sectional study of clinician survey and pharmacy data. Participants. Forty-five VA clinicians from five primary care clinics of one VA medical center. Measures. Survey of pain-related attitudes and behaviors, satisfaction with treatment resources, and job satisfaction; percentage of patients in clinicians' panels prescribed opioids (PCPO). Results. Seventy-one percent of clinicians felt moderately or strongly confident in their ability to treat chronic pain, and 77% moderately or strongly agreed that skilled pain management is a high priority. However, 73% moderately or strongly agreed that patients with chronic pain are a major source of frustration and 38% reported moderate or greater dissatisfaction with their ability to provide optimal pain treatment. Fifty-two percent moderately or strongly agreed that their management is influenced by previous experiences with patients addicted to drugs. The mean PCPO was 16.5% (SD = 6.7). In bivariate comparisons, clinician panel size, job and resource satisfaction, and professional training were associated with opioid prescribing rates. Conclusion. High clinician confidence and interest in treating chronic pain concurrent with low satisfaction with ability to provide optimal treatment suggests a need for more system support. VA primary care clinicians are frequently influenced by fears of contributing to dependence or addiction. The relationships among panel size, job satisfaction, and opioid prescribing rates merit additional investigation.

Original languageEnglish (US)
Pages (from-to)564-571
Number of pages8
JournalPain Medicine
Volume9
Issue number5
DOIs
StatePublished - Jul 2008

Fingerprint

Veterans
Chronic Pain
Opioid Analgesics
Primary Health Care
Aptitude
Job Satisfaction
Pain
Frustration
Pain Management
Therapeutics
Fear
Cross-Sectional Studies
Pharmaceutical Preparations
Surveys and Questionnaires

Keywords

  • Addiction
  • Chronic Pain
  • Narcotics
  • Pain Management
  • Primary Care
  • Satisfaction

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Veterans affairs primary care clinicians' attitudes toward chronic pain and correlates of opioid prescribing rates. / Dobscha, Steven; Corson, Kathryn; Flores, Jennifer A.; Tansill, Erin C.; Gerrity, Martha S.

In: Pain Medicine, Vol. 9, No. 5, 07.2008, p. 564-571.

Research output: Contribution to journalArticle

Dobscha, Steven ; Corson, Kathryn ; Flores, Jennifer A. ; Tansill, Erin C. ; Gerrity, Martha S. / Veterans affairs primary care clinicians' attitudes toward chronic pain and correlates of opioid prescribing rates. In: Pain Medicine. 2008 ; Vol. 9, No. 5. pp. 564-571.
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