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Attitudes and self-reported practices of hand surgeons regarding prescription opioid use.

ABSTRACT: Opioids are routinely prescribed after hand surgery, but there is limited research about surgeon variation in prescription patterns and attitudes toward the use of these drugs. We sought to examine hand surgeons' attitudes, beliefs, and self-reported practices regarding the use of opioids.An invitation to an online cross-sectional survey was sent to 3225 hand surgeons across the USA via email, of whom 502 (16 %) responded. We used previously published data to compare hand surgeons' concerns about potential adverse opioid-related events with those of primary care physicians.Most hand surgeons (76 %) reported prescription opioid abuse to be a big or moderate problem in their communities, and 89 % felt that opioids are overused to treat pain. Nearly all (94 %) were very or moderately confident about their clinical skills regarding opioid prescribing, but only 40 % reported always or often asking about a history of opioid abuse or dependence before scheduling surgery. Most (75 %) were very or moderately comfortable refilling opioid prescriptions following fracture surgery, while only 13 % were comfortable doing so after minor elective surgery. Nearly half (49 %) reported being less likely to prescribe opioids compared to 1 year ago, and 67 % believed that the best approach to reduce postoperative opioid use is to discuss pain management and expectations with the patient before surgery. Compared to primary care physicians, hand surgeons were less likely to be concerned about potential adverse patient (e.g., opioid-related addiction [67 vs. 84 %], death [37 vs. 70 %], sedation [57 vs. 71 %]) and prescriber (e.g., malpractice claim [22 vs. 46 %], prosecution [15 vs. 45 %], censure by state medical boards [16 vs. 44 %]) outcomes.Hand surgeons have become aware of the extent and public health implications of the prescription opioid epidemic, and many are taking an active role by reducing their reliance on these drugs. Additional research using pharmacy data is needed to confirm the extent to which hand surgeons' reliance on prescription opioids is actually decreasing.

SUBMITTER: Menendez ME

PROVIDER: S-EPMC4641080 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Attitudes and self-reported practices of hand surgeons regarding prescription opioid use.

Menendez Mariano E ME Mellema Jos J JJ Ring David D

Hand (New York, N.Y.) 20150501 4

<h4>Background</h4>Opioids are routinely prescribed after hand surgery, but there is limited research about surgeon variation in prescription patterns and attitudes toward the use of these drugs. We sought to examine hand surgeons' attitudes, beliefs, and self-reported practices regarding the use of opioids.<h4>Methods</h4>An invitation to an online cross-sectional survey was sent to 3225 hand surgeons across the USA via email, of whom 502 (16 %) responded. We used previously published data to c ...[more]

PMID: 26568742

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Project description:The use of antibiotics in livestock production is considered a major driver of antibiotic resistance on a global scale. In Vietnam, small- and medium-scale livestock producers dominate the domestic market and regulatory pushes have done little to decrease antibiotic use. In order to inform future policy directions, this study aims to explore knowledge, attitudes, and practices amongst livestock producers to identify their perspectives on antibiotic use and resistance. A total of 392 small- and medium-scale producers specialized in pig, poultry and aquaculture production participated in the study. The results showed that the primary reason for antibiotic use reported by producers was for the treatment of infections (69%). However, prophylactic use was also evident, with farmers reporting other reasons for antibiotic use such as "animals display abnormal symptoms or behaviour" (55%), the "weather is about to change" (25%), or "animals on neighboring farms fall ill" (27%). Only one-fifth of producers demonstrated favorable attitudes towards antibiotic use and preventing antibiotic resistance. Moreover, administering antibiotics remained the preferred countermeasure directly applied by farmers at the first indication of disease (17%), compared to enacting hygiene (10%) or quarantine (5%) measures. The results showed divergent trends amongst producers, with pig producers demonstrating higher levels of knowledge, more favorable attitudes, and higher self-reported utilization of good practice. Better knowledge, attitudes, and practices were also associated with producers who engaged in efforts to explore information on antibiotic use and resistance, which improved incrementally with the number of sources consulted and hours invested. However, there were some areas where increased knowledge or more favorable attitude scores did not translate into better practices. For instance, producers with higher levels of formal education performed significantly better than those with lower education in terms of knowledge and attitude, though both groups reported similar practices. The findings of this study may support future interventions to prevent both antibiotic misuse and the development of antimicrobial resistance.

Dataset Information

Attitudes and self-reported practices of hand surgeons regarding prescription opioid use.

Publications

Attitudes and self-reported practices of hand surgeons regarding prescription opioid use.

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