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Cross Disciplinary Role Agreement is Needed When Coordinating Long-Term Opioid Prescribing for Cancer: a Qualitative
K F Giannitrapani1,2, M J Silveira3,4, A Azarfar5,6
1Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA. Karleen@stanford.edu.
Journal of General Internal Medicine
|May 5, 2021
Summary
Interdisciplinary providers often disagree on who should manage opioid pain for cancer patients. Clearer communication and role negotiation are crucial for effective cancer pain management.
Area of Science:
- Oncology
- Pain Management
- Healthcare Systems
Background:
- Cancer pain is a common and significant issue, frequently managed by primary care providers (PCPs) and oncology providers.
- Effective management often involves collaboration between these disciplines.
Purpose of the Study:
- To explore interdisciplinary provider experiences with coordinating opioid pain management for chronic cancer pain patients.
- To understand challenges and facilitators in integrated healthcare systems.
Main Methods:
- Qualitative research design using 20 semi-structured interviews.
- Participants included primary care providers (PCPs) and oncology-based personnel (OBPs) at VA Medical Centers.
- Data analyzed using deductive and inductive coding approaches.
Main Results:
- Providers generally preferred a single prescriber but disagreed on roles for cancer pain management.
- Multiple prescribers may be necessary in specific situations, like pain crises.
- Barriers to interdisciplinary care coordination were identified, highlighting the need for real-time communication and negotiation.
Conclusions:
- Real-time negotiation between PCPs and oncology is essential for effective opioid pain management in cancer patients.
- Lack of role clarity can lead to delays in appropriate pain management.
- Improved interdisciplinary communication can enhance care coordination.
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