Perceptions of patient provider agreements.

Area of Science:

• Pain Management
• Public Health
• Healthcare Policy

Background:

• Patient-provider agreements (PPAs) are increasingly utilized in clinical practice.
• Evidence regarding the effectiveness of PPAs in preventing prescription opioid misuse and diversion is limited.
• There is a lack of comprehensive guidelines for healthcare providers on the use of PPAs.

Purpose of the Study:

• To explore patient and prescriber perceptions of patient-provider agreements (PPAs).
• To understand the administration, content, effectiveness, and utility of PPAs from both patient and provider perspectives.

Main Methods:

• Conducted eight focus groups with 40 patients who had signed a PPA and 40 prescribers who had administered at least one PPA.
• Developed topic guides based on prior literature for focus group discussions.
• Performed independent content analysis of transcribed focus groups to identify recurring themes.

Main Results:

• PPA usage varied by physician specialty, with general practitioners using them least despite insurer pressure.
• Many patients signed PPAs in emergency departments, often without fully understanding their purpose or content.
• Both patients and prescribers questioned the legal standing of PPAs and agreed they would not prevent opioid misuse, though they differed on valued content.

Conclusions:

• Identified key themes regarding PPA administration, content, effectiveness, and utility, highlighting areas for improvement.
• Observed trends in PPA use require further investigation.
• Developing patient-centered PPAs necessitates understanding patient priorities regarding content.