Patient and provider characteristics associated with communication about opioids: An observational study.
Cleveland G Shields, Lindsay N Fuzzell, Sharon L Christ and 1 others
PMID 30552013WHAT IT FOUND
Opioid safety and mental health talk was uncommon.
More patient anxiety, stronger alliance, and prescriber burnout were linked to more such talk, while prescriber negativity toward opioids was linked to less.
Key findings
01Mental health and opioid safety talk occurred in 39% of cases.
02Opioid and pain management talk was more extensive when patients reported more pain catastrophizing and when PCPs reported a more psychosocial orientation.
03Opioid safety and mental health talk was more likely when patients reported more anxiety or a stronger working alliance, and when PCPs reported more burnout; it was less likely when PCPs reported more negative attitudes toward opioids.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysed sample was small and came from one academic medical center, so results may not generalise. Most clinicians were female and White, and patients were mostly female and of low socioeconomic status. The coding system was adapted for this study and was not validated in other studies. The study did not capture initial pain assessment, diagnosis, or opioid initiation. The analysis was exploratory and did not adjust for multiple comparisons.
Declared interests
Publication types indicate NIH extramural and non-U.S. government research support. The supplied text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not read these associations as proof that talking more about opioids or mental health improves pain, safety, or opioid use. The study did not test outcomes, and the sample was small.