General surgeons' perspectives on post-discharge opioid prescribing: A qualitative study

Area of Science:

• Surgical Pain Management
• Opioid Prescribing Practices
• Health Services Research

Background:

• Understanding surgeon perspectives on post-discharge opioid prescribing is vital for effective pain management and reducing opioid-related harms.
• Opioid misuse and addiction remain significant public health concerns, necessitating a closer look at prescribing patterns.

Purpose of the Study:

• To explore North American general surgeons' views on prescribing opioids after hospital discharge.
• To identify factors influencing surgeons' opioid prescribing decisions.

Main Methods:

• Qualitative study utilizing semi-structured interviews with 30 general surgeons across the USA and Canada.
• Thematic analysis of transcribed interviews to identify recurring themes and patterns in surgeon perspectives.

Main Results:

• Surgeons' reliance on opioids is driven by prescribing culture, convenience, patient expectations, and limited expertise with non-opioid alternatives.
• Motivations for opioid minimization include a cultural shift, recognition of non-opioid effectiveness, policy changes, and new research.
• Strategies for tailoring analgesia involve managing patient expectations and implementing robust post-discharge follow-up protocols.

Conclusions:

• Tradition, convenience, and insufficient expertise act as barriers to evidence-based opioid prescribing.
• Addressing these barriers is essential for optimizing patient analgesia and mitigating the risks associated with opioid use.
• A shift towards more judicious opioid prescribing and enhanced pain management strategies is needed.