Primary care specialty, resident status, and male gender correlate with controlled drug contract use

With prescription drug abuse rising, physicians are often ambivalent about prescribing controlled drugs. To address their concerns, physicians widely use controlled drug contracts (CDC); however, CDC use is poorly studied. This preliminary study characterizes CDC users and identifies factors associated with CDC use.

Data were collected from a Web-based survey of University of Oklahoma College of Medicine medical trainee and faculty attitudes and prescribing practices regarding controlled drugs. Recruited via e-mail, participants submitted responses anonymously for a 6-week period from January through March 2004. Associations between demographic variables and participants' responses were analyzed using chi2 analysis to determine correlates of CDC use. Demographic variables included training status (medical student, resident, or faculty), age, gender, and faculty specialty. Variables of interest derived from the survey were CDC use, how respondents compared the risks and benefits of controlled drugs, and patient diagnosis.

One hundred ninety-six surveys were submitted, with an estimated response rate of 20% to 30%. CDC use correlated with male gender (p = .0099), resident status (p = .0099), primary care specialty among faculty (p = .0001), and risk/benefit assessment (p = .04) but not patient diagnosis (p = .19) or participant age (p = .40).

Despite limitations, the study findings suggest that a physician's gender, training status, medical specialty, and comparison of the risks and benefits of controlled drugs are factors that determine CDC use.