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PMID- 29215508
DCOM- 20180108
LR  - 20180108
IS  - 1873-233X (Electronic)
IS  - 0029-7844 (Linking)
VI  - 131
IP  - 1
DP  - 2018 Jan
TI  - Opioid Knowledge and Prescribing Practices Among Obstetrician-Gynecologists.
PG  - 150-157
LID - 10.1097/AOG.0000000000002407 [doi]
AB  - OBJECTIVE: To describe obstetrician-gynecologists' (ob-gyns) knowledge and
      prescribing practices regarding opioid analgesics. METHODS: We conducted a
      cross-sectional survey of a national sample of American College of Obstetricians 
      and Gynecologists Fellows and Junior Fellows who are part of the Collaborative
      Ambulatory Research Network. We used a sequential mixed-method approach. We
      collected data on opioid knowledge and typical prescribing practices, including
      number, type, and indication for prescriptions. We determined adherence to four
      recommended practices: 1) screening for dependence, 2) prescribing the smallest
      amount required, 3) tailoring prescriptions, and 4) counseling on proper
      disposal. We also explored variables associated with prescribing practices.
      RESULTS: Sixty percent (179/300) of sampled members responded. Respondents
      reported prescribing a median of 26 (5-80) pills per patient across all
      indications combined. Ninety-eight percent prescribed opioids after surgery and a
      smaller proportion for nonsurgical indications: vaginal birth (22%), ovarian
      cysts (30%), endometriosis (24%), and chronic pelvic pain of unknown cause (18%).
      The number prescribed varied only by indication for the prescription. Nineteen
      percent reported adherence to three or more (of four) recommended practices.
      There was no significant difference in the median number of pills prescribed
      between those who reported adherence to at least one compared with those who did 
      not adhere to any recommended practices (25 [interquartile range 25-30] vs 28
      [interquartile range 20-30], P=.58). Regarding knowledge, 81% incorrectly
      identified the main source of misused opioids, which is through diversion from a 
      friend or family member, and 44% did not know how to properly dispose of unused
      prescription opioids. CONCLUSION: Obstetrician-gynecologists reported prescribing
      a median of 26 opioid pills across all indications combined. Amount prescribed
      varied widely by indication but not by reported adherence to recommended
      prescribing practices. This study highlights an urgent need for increased efforts
      to improve ob-gyns' knowledge of opioid use, misuse, disposal, and best
      prescribing practices.
FAU - Madsen, Annetta M
AU  - Madsen AM
AD  - Department of Obstetrics and Gynecology, Women & Infants' Hospital and Warren
      Alpert Medical School of Brown University, Providence, Rhode Island; and the
      Research Department of the American College of Obstetricians and Gynecologists,
      Washington, DC.
FAU - Stark, Lauren M
AU  - Stark LM
FAU - Has, Phinnara
AU  - Has P
FAU - Emerson, Jenna B
AU  - Emerson JB
FAU - Schulkin, Jay
AU  - Schulkin J
FAU - Matteson, Kristen A
AU  - Matteson KA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obstet Gynecol
JT  - Obstetrics and gynecology
JID - 0401101
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Analgesics, Opioid/*administration & dosage/adverse effects
MH  - Attitude of Health Personnel
MH  - Cross-Sectional Studies
MH  - Drug Prescriptions/*statistics & numerical data
MH  - Drug Utilization/*statistics & numerical data/trends
MH  - Female
MH  - Gynecology/methods
MH  - Humans
MH  - Male
MH  - Needs Assessment
MH  - Obstetrics/methods
MH  - Opioid-Related Disorders/etiology/*prevention & control
MH  - Practice Patterns, Physicians'/*trends
MH  - Statistics, Nonparametric
MH  - *Surveys and Questionnaires
MH  - United States
EDAT- 2017/12/08 06:00
MHDA- 2018/01/09 06:00
CRDT- 2017/12/08 06:00
PHST- 2017/12/08 06:00 [pubmed]
PHST- 2018/01/09 06:00 [medline]
PHST- 2017/12/08 06:00 [entrez]
AID - 10.1097/AOG.0000000000002407 [doi]
PST - ppublish
SO  - Obstet Gynecol. 2018 Jan;131(1):150-157. doi: 10.1097/AOG.0000000000002407.