'Once that's worn off, we could discuss whether you need more': provider perspectives on communicating with patients and other providers about prescription opioids.

Abstract

Background: Prescriber-patient communication plays a crucial role in understanding patients' needs, while reducing risks for developing an opioid use disorder (OUD), yet research on this is sparse. As such, the need to understand healthcare providers' skills, comfort, and confidence when discussing opioids with patients and other providers is an important step in balancing patients' needs from a pain perspective and risks from an OUD perspective.

Method: We interviewed 32 Massachusetts providers (physicians, physician associates, nurse practitioners, and dental practitioners) to assess their communication strategies with patients and other providers. Interviews were conducted online (January - September 2021) and were transcribed verbatim, coded, and analyzed using deductive content analysis.

Results: Contextualized in the Health Education Theory, one major theme was how providers communicated with patients about opioids, including their tone, use of language, and the content they covered. Providers described frequently encountering patients who expressed fears and concerns about opioid addiction and did not want an opioid prescription. Another major theme, related to the ongoing process of preventing problems with opioids was a focus on provider engagement in follow-up, including checking if a prescription was filled, having the patient come back to the office, or calling another provider after a certain duration. Recommendations about communication with patients and other providers were also discussed.

Conclusions: Overall, open, supportive, tailored communication with patients and other providers was deemed essential when considering opioid prescriptions. Further research is recommended to learn about the status of opioid-prescription knowledge, beliefs, and practices within the fourth wave of the current opioid overdose epidemic.