Hospitalists need strategies for providing adequate pain relief
(HealthDay)—Hospitalists report limited success and satisfaction for management of acute exacerbations of chronic pain with opioids, according to a study published online May 9 in the Journal of Hospital Medicine.
Susan L. Calcaterra, M.D., M.P.H., from the Denver Health Medical Center, and colleagues conducted a qualitative analysis to examine physicians' attitudes, beliefs, and practices toward opioid prescribing. Semistructured interviews were conducted among 25 hospitalists from two university hospitals, a safety-net hospital, a Veterans Affairs hospital, and a private hospital. Transcribed interviews were analyzed and emerging themes were identified.
The researchers found that hospitalists felt confident in their ability to control acute pain using opioid medications but when managing acute exacerbations of chronic pain with opioids they perceived limited success. Negative sentinel events were recounted that altered opioid prescribing practices in the hospital setting and at the time of hospital discharge. Prescribing opioids was described as a pragmatic tool to facilitate hospital discharges or prevent readmissions; at times this left hospitalists feeling conflicted about the long-term impact on patients.
"Strategies to provide adequate pain relief to hospitalized patients, which allow hospitalists to safely and optimally prescribe opioids while maintaining current standards of efficiency, are urgently needed," the authors write.
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