Clinician Perspectives of Managing Opioid Related Transitions.

PURPOSE: Opioid-related transitions (OrTs) are critical periods requiring focused support and tailored pain management, yet remain poorly understood. This study aimed to examine clinician perspectives on and approaches to managing recurring opioid prescriptions during OrTs for patients with chronic pain.

DESIGN

This study used a qualitative descriptive design.

METHODS

Semi-structured individual interviews were conducted with 21 interdisciplinary clinicians, including prescribers and nonprescribers, within a large health system in the southeastern United States. Data were analyzed using rapid qualitative analysis.

RESULTS

We identified three themes related to our objective. The first theme, "multiple and varied transitions in opioid management," included the following subthemes: (1) care setting transitions, (2) clinician transitions, and (3) medication prescribing transitions. The second theme, "clinician approaches to opioid management," included the following three clinician approaches: (1) accept the patient, (2) accept the patient with guardrails, and (3) defer responsibility to other clinicians. The last theme, "influencing factors to OrT," included: (1) opioid prescribing policies, (2) power dynamics, and (3) system-level barriers and facilitators.

CONCLUSION

OrTs often occur amid clinician-reported barriers, limited support, and discomfort with opioid prescribing and management, particularly during changes in care settings, clinicians, and opioid regimens.

CLINICAL IMPLICATIONS: These findings underscore the need for improved care coordination and enhanced systems-level support for clinicians who provide care to patients during OrTs. Best practices that support optimal patient pain management are urgently needed to guide clinician decision-making regarding opioid prescribing and management during transitions of care.