Medical residents beliefs and concerns about using opioids to treat chronic cancer and noncancer pain: A pilot study

Abstract

Abstract-This study assessed and compared residents' beliefs and concerns about using opioids for treating pain in patients with cancer and noncancer low back pain (NLBP). Participants included 72 Internal Medicine and Medicine-Pediatrics residents who completed a survey questionnaire. Based on a scale of 0 = "No concern" to 10 = "Very concerned," residents expressed greater concern that treating NLBP with opioids, compared with cancer-related pain, causes addiction (6.01 vs 1.15), abuse (5.57 vs 1.39), and side effects (4.76 vs 2.87); limits other treatments (5.36 vs 1.30); draws criticism from faculty (4.33 vs 0.88); or risks sanctioning (state board 4.12 vs 1.12, legal 4.06 vs 1.17); p < 0.001 for each (paired t-tests). They had more comfort (8.94 vs 4.31) and more empathy (9.09 vs 6.79) using opioids to treat for cancer pain than NLBP and would give whatever doses necessary for pain control (8.41 vs 3.66); p < 0.001 for each. Our findings show that residents are far more concerned about using opioids to treat NLBP than cancerrelated pain.

Predictors of Physician Compassion, Empathy, and Related Constructs: a Systematic Review

“…Evidence related to the frequency of presentation was limited to three studies, two of which showed that the frequency of presentation predicts lower ECRC 102 , 138 , and one study showing no effect 61 . With regard to pain, having or not having pain in general showed no effect on ECRC 101 , 178 , while in the presence of pain, pain visibility 44 and pain related to cancer 187 predicted greater ECRC. Other evidence regarding illness type was based on single studies and was of limited coherence and represented by single studies 38 , 46 , 101 , 128 , 138 , 152 , 154 , 168 , 178 , 182 , 188 , 189 .…”

Predictors of Physician Compassion, Empathy, and Related Constructs: a Systematic Review

“…Evidence related to the frequency of presentation was limited to three studies, two of which showed that the frequency of presentation predicts lower ECRC 102 , 138 , and one study showing no effect 61 . With regard to pain, having or not having pain in general showed no effect on ECRC 101 , 178 , while in the presence of pain, pain visibility 44 and pain related to cancer 187 predicted greater ECRC. Other evidence regarding illness type was based on single studies and was of limited coherence and represented by single studies 38 , 46 , 101 , 128 , 138 , 152 , 154 , 168 , 178 , 182 , 188 , 189 .…”

Physicians’ Knowledge of and Attitudes Toward Use of Opioids in Long‐Term Care Facilities

“…For example, Kim et al . found that addiction was one of the four major barriers and Roth et al . found that physicians expressed more concern about addiction when opioids were prescribed for patients with noncancerous low‐back pain as compared to patients with cancer.…”

Practical Considerations for the Use of Tapentadol Prolonged Release for the Management of Severe Chronic Pain

“…[87][88][89] An abuse liability trial in opioid-experienced patients versus oral hydromorphone that was early in the clinical development of tapentadol reported a similar liking potential for oral tapentadol. In the United States and Europe, tapentadol is considered a scheduled substance 33,35 ; in the United States, the Food and Drug Administration has implemented a Risk Evaluation and Mitigation Strategy for controlled substances to improve prescribing practices and reduce drug diversion.…”

Predictors of Physician Compassion, Empathy, and Related Constructs: a Systematic Review

“…Evidence related to the frequency of presentation was limited to three studies, two of which showed that the frequency of presentation predicts lower ECRC 102 , 138 , and one study showing no effect 61 . With regard to pain, having or not having pain in general showed no effect on ECRC 101 , 178 , while in the presence of pain, pain visibility 44 and pain related to cancer 187 predicted greater ECRC. Other evidence regarding illness type was based on single studies and was of limited coherence and represented by single studies 38 , 46 , 101 , 128 , 138 , 152 , 154 , 168 , 178 , 182 , 188 , 189 .…”

Physicians’ Knowledge of and Attitudes Toward Use of Opioids in Long‐Term Care Facilities

“…For example, Kim et al . found that addiction was one of the four major barriers and Roth et al . found that physicians expressed more concern about addiction when opioids were prescribed for patients with noncancerous low‐back pain as compared to patients with cancer.…”

Practical Considerations for the Use of Tapentadol Prolonged Release for the Management of Severe Chronic Pain

“…[87][88][89] An abuse liability trial in opioid-experienced patients versus oral hydromorphone that was early in the clinical development of tapentadol reported a similar liking potential for oral tapentadol. In the United States and Europe, tapentadol is considered a scheduled substance 33,35 ; in the United States, the Food and Drug Administration has implemented a Risk Evaluation and Mitigation Strategy for controlled substances to improve prescribing practices and reduce drug diversion.…”

Predictors of Physician Compassion, Empathy, and Related Constructs: a Systematic Review

“…Evidence related to the frequency of presentation was limited to three studies, two of which showed that the frequency of presentation predicts lower ECRC 102 , 138 , and one study showing no effect 61 . With regard to pain, having or not having pain in general showed no effect on ECRC 101 , 178 , while in the presence of pain, pain visibility 44 and pain related to cancer 187 predicted greater ECRC. Other evidence regarding illness type was based on single studies and was of limited coherence and represented by single studies 38 , 46 , 101 , 128 , 138 , 152 , 154 , 168 , 178 , 182 , 188 , 189 .…”

Physicians’ Knowledge of and Attitudes Toward Use of Opioids in Long‐Term Care Facilities

“…For example, Kim et al . found that addiction was one of the four major barriers and Roth et al . found that physicians expressed more concern about addiction when opioids were prescribed for patients with noncancerous low‐back pain as compared to patients with cancer.…”

Practical Considerations for the Use of Tapentadol Prolonged Release for the Management of Severe Chronic Pain

“…[87][88][89] An abuse liability trial in opioid-experienced patients versus oral hydromorphone that was early in the clinical development of tapentadol reported a similar liking potential for oral tapentadol. In the United States and Europe, tapentadol is considered a scheduled substance 33,35 ; in the United States, the Food and Drug Administration has implemented a Risk Evaluation and Mitigation Strategy for controlled substances to improve prescribing practices and reduce drug diversion.…”