Awareness and perceptions of patient-provider opioid agreement among clinicians in Singapore

Opioids are potent analgesics associated with potentially serious adverse effects, including abuse. The use of patient-provider opioid agreements is a regulatory approach in opioid prescription aimed at achieving pain management goals while minimising adverse effects. While national guidelines in Singapore recommend their use, there are limited data regarding the frequency of use and the experiences associated with them. This study aimed to examine clinicians' awareness, perceptions and frequency of use of opioid agreements in Singapore.

A multicentre cross-sectional electronic survey was conducted among doctors from various clinical specialties in Singapore. The survey questionnaire, hosted on a Singapore Government-secured website, was emailed as a link to 1051 potential respondents and remained active for 3 months. All responses were received anonymously and securely collated.

There were 139 questionnaire responses, among which 129 (92.8%) participants were opioid prescribers. Eighty-six (66.7%) participants were unaware of the existence of opioid agreements. Only 21 (16.3% of total, 48.8% of aware) participants were actual users of opioid agreements; 95.4% of participants who were aware of opioid agreements felt that they were useful.

Awareness and use of opioid agreements among clinicians in Singapore are low, varying by pain management experience, prescribing frequency and practice specialty. Clinicians familiar with opioid agreements generally accept their clinical usefulness. Education and research are needed to increase awareness and develop guidelines for standardised administration of opioid agreements.