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Analgesia and Pain Management01:25

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Exploring Opioid Prescriber Decision-Making: A Qualitative Study.

Jamie L Smith1, Molly M Jeffery1, Jason S Egginton1

  • 1Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.

Pharmacoepidemiology and Drug Safety
|May 29, 2026
PubMed
Summary
This summary is machine-generated.

Opioid prescribing decisions are shaped by prescriber, patient, and practice factors. Institutional guidelines and peer input aid clinicians in managing complex pain cases and communicating opioid use effectively.

Keywords:
decision makingopioidspain managementqualitative research

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Area of Science:

  • Medical Practice
  • Pain Management
  • Qualitative Research

Background:

  • Opioid prescribing is complex, influenced by multiple factors.
  • Understanding prescriber decision-making is crucial for safe opioid management.

Purpose of the Study:

  • To explore the multifaceted decision-making process of clinicians prescribing opioids.
  • Investigate factors influencing opioid prescribing in primary care, surgery, and pain management.

Main Methods:

  • Qualitative study involving 20 individual interviews and 4 focus groups with 21 clinicians (physicians, NPs, PAs).
  • Utilized a conceptual model with domains: prescriber, patient, and practice environment characteristics.
  • Data analyzed using a common codebook after rapid template-based summarization.

Main Results:

  • Prescriber factors included training and beliefs; patient factors involved pain, comorbidities, and demographics.
  • Clinicians' perceptions (e.g., age and risk) influenced decisions; challenges arose with 'legacy patients' and care transitions.
  • Practice environment factors like guidelines and oversight promoted conservative opioid use and eased decision-making burden.

Conclusions:

  • Opioid prescribing is a complex interplay of prescriber, patient, and practice environment factors.
  • Practice resources, including peer support and guidelines, enhance clinician decision-making and patient communication.
  • These resources are vital for managing patients with complex histories and characteristics influencing opioid decisions.