American journal of surgery · 2025
General surgeons' perspectives on post-discharge opioid prescribing: A qualitative study.
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Pook Makena, Ghezeljeh Tahereh Najafi, Elhaj Hiba, Rajabiyazdi Fateme, Balvardi Saba, Wong Stephanie, Boutros Marylise, Fried Gerald M, Lee Lawrence, Feldman Liane S, Fiore Julio F
Аннотация
BACKGROUND: Understanding surgeons' perspectives on post-discharge opioid prescribing is crucial for optimizing pain management while mitigating opioid-related harms.
OBJECTIVE: To describe the perspectives of North American general surgeons towards opioid prescribing after hospital discharge.
METHODS: This qualitative study involved semi-structured interviews with 30 general surgeons in the USA and Canada. Interviews were audio-recorded, transcribed verbatim, and continued until thematic saturation. Data were analyzed using inductive thematic analysis.
RESULTS: Three themes were derived: motives for relying on opioids, motives for opioid minimization, and strategies for tailoring analgesia. Reliance on opioids was motivated by prescribing culture, convenience, patients' expectations, apprehension towards non-opioid analgesics, and limited pain management expertise. Motivations for opioid-minimization included cultural shift, non-opioids' effectiveness, policy, and emerging research. Strategies for tailoring prescribing included addressing patient expectations and post-discharge follow-up.
CONCLUSIONS: Barriers to evidence-based prescribing, including tradition, convenience, and lacking expertise, should be addressed to optimize analgesia and mitigate opioid-related harms.
OBJECTIVE: To describe the perspectives of North American general surgeons towards opioid prescribing after hospital discharge.
METHODS: This qualitative study involved semi-structured interviews with 30 general surgeons in the USA and Canada. Interviews were audio-recorded, transcribed verbatim, and continued until thematic saturation. Data were analyzed using inductive thematic analysis.
RESULTS: Three themes were derived: motives for relying on opioids, motives for opioid minimization, and strategies for tailoring analgesia. Reliance on opioids was motivated by prescribing culture, convenience, patients' expectations, apprehension towards non-opioid analgesics, and limited pain management expertise. Motivations for opioid-minimization included cultural shift, non-opioids' effectiveness, policy, and emerging research. Strategies for tailoring prescribing included addressing patient expectations and post-discharge follow-up.
CONCLUSIONS: Barriers to evidence-based prescribing, including tradition, convenience, and lacking expertise, should be addressed to optimize analgesia and mitigate opioid-related harms.