Doctors may lack self-awareness when prescribing opioids

Doctors may lack self-awareness when prescribing opioids

As health providers struggle to curb the epidemic of opioid abuse, a recent study has found that 65% of emergency department (ED) physicians surveyed underestimated how often they prescribed the highly addictive pain killers to patients.

Those rates dropped after they saw their actual data.

The year-long study focused on how doctors perceive themselves relative to their peers when it comes to prescribing opioids. Most felt they were restrained, but the results showed otherwise.

In the study, the team surveyed 109 emergency medicine providers at four different hospital EDs.

The researchers asked them to report their perceived opioid prescribing rates compared to their peers. Then the team showed them where they actually were on that spectrum.

Some 65% of doctors surveyed prescribed more opioids that they thought they did.

The team found participants discharged 119,428 patients and wrote 75,203 prescriptions, of which 15,124 (or about 20%) were for opioids over the course of the 12-month study.

The researchers then monitored the doctors after they were shown their actual prescription rates.

They found that everyone showed an overall decrease in prescribing opioids.

After seeing their real data, the people with inaccurate self-perceptions, on average, had 2.1% fewer opioid prescriptions per 100 patients six months later and 2.2% fewer prescriptions per 100 patients at 12 months.

The study likened the physicians’ initial self-perceptions to the majority of drivers feeling they are above average — a statistical impossibility.

The researchers believe the shock many felt upon seeing the reality of their actions versus their perceptions motivated them to change their behavior.

The team pointed out that this problem extends beyond emergency departments. In fact, only about 5%-10% of all opioid prescriptions are generated by ED physicians.

Despite making progress on the opioid epidemic, researchers cannot assume providers are behaving optimally and have all the information they need to do what we are asking of them.

Most believe they are doing the right thing, but it is important to directly address this thinking to be sure they are not part of the problem.

The study is published in the journal Academic Emergency Medicine.

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News source: University of Colorado Anschutz Medical Campus.
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