Clinicians need well-developed strategies to provide pain relief to hospitalized patients while safely prescribing opioids, according to research in the Journal of Hospital Medicine.
Susan L. Calcaterra, MD, MPH, Department of Hospital Medicine at the Denver Health Medical Center, and colleagues conducted in-depth, semi-structured interviews of 25 hospitalists at a variety of hospital settings in Denver and Charleston, South Carolina, to understand physician-held attitudes, beliefs, and practices toward opioid prescribing during hospitalization and at discharge.
The researchers found that while hospitalists felt confident in their ability to control acute pain via opioid prescriptions, they perceived limited success and patient satisfaction when managing acute incidences of chronic pain via opioids.
“Pain is a frequent symptom among patients in the hospital,” Dr Calcaterra noted. “Pain management is a key quality indicator … and hospitalists are encouraged to frequently assess and treat pain. Optimal opioid prescribing, described as safe, patient-centered, and informed opioid prescribing, may be at odds with the priorities of current hospital care, which focuses on patient-reported pain control rather than the potential long-term consequences of opioid use.”
“Hospitalists described prescribing opioids as a pragmatic tool to facilitate hospital discharges or prevent readmissions,” Dr Calcaterra concluded. “At times, this left them feeling conflicted about how this practice could impact the patient over the long term.”
- Calcaterra SL, Drabkin AD, Leslie SE, et al. The hospitalist perspective on opioid prescribing: A qualitative analysis. J Hosp Med. 2016; doi: 10.1002/jhm.2602