THE PATTERN AND INFLUENCING FACTORS OF OPIOID-PRESCRIBING BEHAVIOR AMONG EMERGENCY PHYSICIANS IN THE QASSIM REGION: A...

In recent decades, opioid misuse has become a major global public health concern, with significant contributions to morbidity and mortality. Emergency departments (EDs) are frequent sites of opioid initiation, yet prescribing practices vary widely among physicians. Previous research in the Western region of Saudi Arabia demonstrated variability in prescribing influenced by physician demographics and experience. However, no prior study has assessed these patterns in the Qassim region.

This study aimed to evaluate the pattern and influencing factors of opioid-prescribing behavior among emergency physicians in the Qassim region of Saudi Arabia.

A cross-sectional study was conducted in March 2025 among emergency physicians in Qassim hospitals. A self-administered 22-item questionnaire assessed demographic and professional characteristics along with determinants of opioid-prescribing behavior using a five-point Likert scale. An overall agreement score was calculated. Descriptive statistics, t-tests, and one-way ANOVA with Tukey's post-hoc analysis were performed using SPSS v26, with p<0.05 considered significant.

A total of 104 physicians completed the survey. The most highly rated determinants of prescribing were the patient's apparent distress (4.4±0.8), medications already administered (4.3±0.8), reported pain score (4.0±0.9), vital signs/physical exam findings (4.0±1.1), and diagnosis thought to be the cause of pain (4.0±0.9). The least influential factors were family/friends' experiences (1.9±1.0), the belief that EDs are a major source of illicit opioids (2.5±1.2), and colleagues' prescribing culture (2.6±1.2). The agreement score differed significantly by gender (p=0.007), number of shifts per month (p=0.004), and years of practice (p<0.001). Post-hoc analysis confirmed that physicians with >10 years of experience scored significantly higher than those with 1-2 years.

Emergency physicians in Qassim demonstrated prescribing patterns primarily guided by objective clinical indicators of pain. Unlike the Western region, significant variation was observed by gender, workload, and years of practice. These findings highlight the need for structured educational interventions for junior physicians, optimization of shift schedules, and region-specific guidelines to ensure safe and consistent opioid prescribing.