Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing Communities Study

Daniel M. Walker; Janet E. Childerhose; Sadie Chen; Nicolette Coovert; Rebecca D. Jackson; Natasha Kurien; Ann Scheck McAlearney; Jaclyn Volney; Daniel P. Alford; Julie Bosak; Douglas R. Oyler; Laura K. Stinson; Melika Behrooz; Mia Cara Christopher; Mari Lynn Drainoni

doi:10.1016/j.drugalcdep.2022.109342

Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing Communities Study

Daniel M. Walker, Janet E. Childerhose, Sadie Chen, Nicolette Coovert, Rebecca D. Jackson, Natasha Kurien, Ann Scheck McAlearney, Jaclyn Volney, Daniel P. Alford, Julie Bosak, Douglas R. Oyler, Laura K. Stinson, Melika Behrooz, Mia Cara Christopher, Mari Lynn Drainoni

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Background: Community-based perspectives are needed to more broadly inform policy-makers, public health practitioners, prescribers, and pharmacists about community-led and broader efforts to reduce opioid overprescribing, and ultimately reduce prescription opioid use disorder, overdoses and fatalities. The aim of this study is to explore community-based perspectives on efforts to change opioid prescribing practices in their communities. Methods: Semi-structured interviews were conducted with 388 community stakeholders across four states (Kentucky, Massachusetts, New York, Ohio) from November 2019 to January 2020 about community approaches and goals of community-led responses to the opioid crisis. Data analysis combined deductive and inductive approaches to identify themes and sub-themes related to improving opioid prescribing practices. Results: Three major themes and different subthemes were characterized: (1) acknowledging progress (i.e., healthcare providers being part of the solution, provider education, and prescription drug monitoring programs); (2) emergent challenges (i.e., physician nonadherence with safer opioid prescribing guidelines, difficulty identifying appropriate use of opioids, and concerns about accelerating the progression from opioid misuse to drug abuse); and (3) opportunities for change (i.e., educating patients about safer use and proper disposal of opioids, expanding prescriber and pharmacist education, changing unrealistic expectations around eliminating pain, expanding and increasing insurance coverage for alternative treatment options). Conclusions: Community stakeholders appeared to support specific opportunities to reduce prescription opioid misuse and improve safer prescribing. The opportunities included culture change around pain expectations, awareness of safe disposal, additional provider education, and increased coverage and acceptability of non-opioid treatments.

Original language	English
Article number	109342
Journal	Drug and Alcohol Dependence
Volume	233
DOIs	https://doi.org/10.1016/j.drugalcdep.2022.109342
State	Published - Apr 1 2022

Bibliographical note

Publisher Copyright:
© 2022 Elsevier B.V.

Funding

This research was supported by the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration through the NIH HEAL (Helping to End Addiction Long-term SM ) Initiative under award numbers UM1DA049394 , UM1DA049406 , UM1DA049412 , UM1DA049415 , UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939 ). This study protocol (Pro00038088) was approved by Advarra Inc., the HEALing Communities Study single Institutional Review Board. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration or the NIH HEAL Initiative SM .

Funders	Funder number
National Institutes of Health (NIH)
Author National Institute on Drug Abuse DA031791 Mark J Ferris National Institute on Drug Abuse DA006634 Mark J Ferris National Institute on Alcohol Abuse and Alcoholism AA026117 Mark J Ferris National Institute on Alcohol Abuse and Alcoholism AA028162 Elizabeth G Pitts National Institute of General Medical Sciences GM102773 Elizabeth G Pitts Peter McManus Charitable Trust Mark J Ferris National Institute on Drug Abuse	UM1DA049417
Substance Abuse and Mental Health Services Administration	UM1DA049412, UM1DA049394, UM1DA049415, NCT04111939, UM1DA049406

Keywords

Community
HEALing Communities Study
Opioid prescribing
Qualitative
Safer prescribing

ASJC Scopus subject areas

Toxicology
Pharmacology
Psychiatry and Mental health
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.drugalcdep.2022.109342

Cite this

Walker, D. M., Childerhose, J. E., Chen, S., Coovert, N., Jackson, R. D., Kurien, N., McAlearney, A. S., Volney, J., Alford, D. P., Bosak, J., Oyler, D. R., Stinson, L. K., Behrooz, M., Christopher, M. C., & Drainoni, M. L. (2022). Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing Communities Study. Drug and Alcohol Dependence, 233, Article 109342. https://doi.org/10.1016/j.drugalcdep.2022.109342

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title = "Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing Communities Study",

abstract = "Background: Community-based perspectives are needed to more broadly inform policy-makers, public health practitioners, prescribers, and pharmacists about community-led and broader efforts to reduce opioid overprescribing, and ultimately reduce prescription opioid use disorder, overdoses and fatalities. The aim of this study is to explore community-based perspectives on efforts to change opioid prescribing practices in their communities. Methods: Semi-structured interviews were conducted with 388 community stakeholders across four states (Kentucky, Massachusetts, New York, Ohio) from November 2019 to January 2020 about community approaches and goals of community-led responses to the opioid crisis. Data analysis combined deductive and inductive approaches to identify themes and sub-themes related to improving opioid prescribing practices. Results: Three major themes and different subthemes were characterized: (1) acknowledging progress (i.e., healthcare providers being part of the solution, provider education, and prescription drug monitoring programs); (2) emergent challenges (i.e., physician nonadherence with safer opioid prescribing guidelines, difficulty identifying appropriate use of opioids, and concerns about accelerating the progression from opioid misuse to drug abuse); and (3) opportunities for change (i.e., educating patients about safer use and proper disposal of opioids, expanding prescriber and pharmacist education, changing unrealistic expectations around eliminating pain, expanding and increasing insurance coverage for alternative treatment options). Conclusions: Community stakeholders appeared to support specific opportunities to reduce prescription opioid misuse and improve safer prescribing. The opportunities included culture change around pain expectations, awareness of safe disposal, additional provider education, and increased coverage and acceptability of non-opioid treatments.",

keywords = "Community, HEALing Communities Study, Opioid prescribing, Qualitative, Safer prescribing",

author = "Walker, \{Daniel M.\} and Childerhose, \{Janet E.\} and Sadie Chen and Nicolette Coovert and Jackson, \{Rebecca D.\} and Natasha Kurien and McAlearney, \{Ann Scheck\} and Jaclyn Volney and Alford, \{Daniel P.\} and Julie Bosak and Oyler, \{Douglas R.\} and Stinson, \{Laura K.\} and Melika Behrooz and Christopher, \{Mia Cara\} and Drainoni, \{Mari Lynn\}",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier B.V.",

year = "2022",

month = apr,

day = "1",

doi = "10.1016/j.drugalcdep.2022.109342",

language = "English",

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Walker, DM, Childerhose, JE, Chen, S, Coovert, N, Jackson, RD, Kurien, N, McAlearney, AS, Volney, J, Alford, DP, Bosak, J, Oyler, DR, Stinson, LK, Behrooz, M, Christopher, MC & Drainoni, ML 2022, 'Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing Communities Study', Drug and Alcohol Dependence, vol. 233, 109342. https://doi.org/10.1016/j.drugalcdep.2022.109342

TY - JOUR

T1 - Exploring perspectives on changing opioid prescribing practices

T2 - A qualitative study of community stakeholders in the HEALing Communities Study

AU - Walker, Daniel M.

AU - Childerhose, Janet E.

AU - Chen, Sadie

AU - Coovert, Nicolette

AU - Jackson, Rebecca D.

AU - Kurien, Natasha

AU - McAlearney, Ann Scheck

AU - Volney, Jaclyn

AU - Alford, Daniel P.

AU - Bosak, Julie

AU - Oyler, Douglas R.

AU - Stinson, Laura K.

AU - Behrooz, Melika

AU - Christopher, Mia Cara

AU - Drainoni, Mari Lynn

PY - 2022/4/1

Y1 - 2022/4/1

N2 - Background: Community-based perspectives are needed to more broadly inform policy-makers, public health practitioners, prescribers, and pharmacists about community-led and broader efforts to reduce opioid overprescribing, and ultimately reduce prescription opioid use disorder, overdoses and fatalities. The aim of this study is to explore community-based perspectives on efforts to change opioid prescribing practices in their communities. Methods: Semi-structured interviews were conducted with 388 community stakeholders across four states (Kentucky, Massachusetts, New York, Ohio) from November 2019 to January 2020 about community approaches and goals of community-led responses to the opioid crisis. Data analysis combined deductive and inductive approaches to identify themes and sub-themes related to improving opioid prescribing practices. Results: Three major themes and different subthemes were characterized: (1) acknowledging progress (i.e., healthcare providers being part of the solution, provider education, and prescription drug monitoring programs); (2) emergent challenges (i.e., physician nonadherence with safer opioid prescribing guidelines, difficulty identifying appropriate use of opioids, and concerns about accelerating the progression from opioid misuse to drug abuse); and (3) opportunities for change (i.e., educating patients about safer use and proper disposal of opioids, expanding prescriber and pharmacist education, changing unrealistic expectations around eliminating pain, expanding and increasing insurance coverage for alternative treatment options). Conclusions: Community stakeholders appeared to support specific opportunities to reduce prescription opioid misuse and improve safer prescribing. The opportunities included culture change around pain expectations, awareness of safe disposal, additional provider education, and increased coverage and acceptability of non-opioid treatments.

AB - Background: Community-based perspectives are needed to more broadly inform policy-makers, public health practitioners, prescribers, and pharmacists about community-led and broader efforts to reduce opioid overprescribing, and ultimately reduce prescription opioid use disorder, overdoses and fatalities. The aim of this study is to explore community-based perspectives on efforts to change opioid prescribing practices in their communities. Methods: Semi-structured interviews were conducted with 388 community stakeholders across four states (Kentucky, Massachusetts, New York, Ohio) from November 2019 to January 2020 about community approaches and goals of community-led responses to the opioid crisis. Data analysis combined deductive and inductive approaches to identify themes and sub-themes related to improving opioid prescribing practices. Results: Three major themes and different subthemes were characterized: (1) acknowledging progress (i.e., healthcare providers being part of the solution, provider education, and prescription drug monitoring programs); (2) emergent challenges (i.e., physician nonadherence with safer opioid prescribing guidelines, difficulty identifying appropriate use of opioids, and concerns about accelerating the progression from opioid misuse to drug abuse); and (3) opportunities for change (i.e., educating patients about safer use and proper disposal of opioids, expanding prescriber and pharmacist education, changing unrealistic expectations around eliminating pain, expanding and increasing insurance coverage for alternative treatment options). Conclusions: Community stakeholders appeared to support specific opportunities to reduce prescription opioid misuse and improve safer prescribing. The opportunities included culture change around pain expectations, awareness of safe disposal, additional provider education, and increased coverage and acceptability of non-opioid treatments.

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KW - HEALing Communities Study

KW - Opioid prescribing

KW - Qualitative

KW - Safer prescribing

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VL - 233

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Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing Communities Study

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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