Going Beyond Guideline-Concordant Opioid Therapy to Improve Patient Safety

Bauer, Scott R.; Katz, Mitchell H.

doi:10.1001/jamainternmed.2017.3030

Cited by 1 publication

(1 citation statement)

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“…In the context of a study focused on opioid prescribing practices (ClinicalTrials.gov Identifier: NCT02564341) (6,14), we conducted qualitative interviews with ten HIV care physicians who had recently participated in a randomized control trial that tested the effect of a collaborative care model on the management of patients receiving chronic opioid therapy. The collaborative care model addressed significant challenges in the management of chronic opioid therapy, including many unique to HIV care, and was based on the TOPCARE model for safer opioid prescribing (http://mytopcare.org), which has been shown to improve the safety of opioid prescribing practices in primary care (15,16). Interviews were conducted [by J.C., who was not involved in the delivery of study interventions] after the trial was concluded.…”

Section: Introduction and Methodsmentioning

confidence: 99%

HIV Physicians and Chronic Opioid Therapy: It’s Time to Raise the Bar

et al. 2018

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Clinical practice that utilizes chronic opioid therapy has been recognized as one major cause of the opioid crisis. Among patients living with HIV, the risks associated with chronic opioid therapy may be complicated by factors such as co-occurring mental health diagnoses, substance use, and economic marginalization. Improving opioid prescribing practices in HIV clinics requires attention to these and other characteristics common to HIV care. In the context of a randomized controlled trial testing an intervention to improve opioid prescribing practices in HIV outpatient clinics, we interviewed physicians about their perspectives on chronic opioid therapy. Overwhelmingly, physicians voiced ambivalence about their own knowledge and comfort with prescription opioids. They raised concerns about the impact of opioid prescribing on patient-provider relationships and the increasing workload associated with prescribing and monitoring patients. In this report, we explore these concerns and propose several strategies for improving clinical care in which chronic opioid therapy is addressed.

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Section: Introduction and Methodsmentioning

confidence: 99%