26 Jul Pain Control Expectations Differ Between Patients from US and Other Countries
MedicalResearch.com Interview with:
Marisha Burden, MD, FACP, SFHM
Associate Professor of Medicine
Division Head of Hospital Medicine
University of Colorado School of Medicine
MedicalResearch.com: What is the background for this study?
Response: The United States has seen a marked increase in opioid prescribing since 2000 and while there has been a slight decline in prescribing since 2012, prescription rates for opioids still remain much higher than in the late 1990’s and are considerably higher when compared to other countries.
The US continues to see opioid-related complications such as overdoses, hospitalizations, and deaths. Hospitalized patients frequently experience pain and opioid medications are often the mainstay for treatment of pain. Studies have suggested that receipt of opioid prescriptions at the time of hospital discharge may increase risk for long-term use.
MedicalResearch.com: What are the main findings?
Response: In this study, we compared opioid prescribing practices during hospitalization and at discharge at four hospitals in the US and seven hospitals in seven other countries. Our main findings were that:
- (1) Compared with patients hospitalized in other countries, a larger percentage of patients in the US were given opioids during their hospitalization and at discharge even after considering pain level,
- (2) satisfaction, beliefs, and expectations about pain control were different between the US patients and the patients in other countries, and
- (3) among patients in the US (and after controlling for pain level), receipt of opioids did not improve patient satisfaction with pain control.
MedicalResearch.com: What should readers take away from your report?
Response: Curbing the opioid epidemic is challenging and will require not only addressing clinician prescribing practices but also exploring and addressing patients’ expectations about their pain control.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: I think we have the opportunity to learn from other sites and other countries about their approach to opioid prescribing practices and pain management. We need to understand more about patient and family experiences and expectations about pain control. We also need to understand our approach to pain control for hospitalized patients recognizing that it is a true balancing act.
MedicalResearch.com: Is there anything else you would like to add?
Response: I am very grateful to our study collaborators who came together to study an important issue that patients, families, caregivers, health care providers and health systems face.
Marisha Burden, Angela Kingston, Mary Anderson Wallace, Jason W Busse, Jordi Casademont, Smitha R Chadaga, Sumitra Chandrasekaran, Marco Cicardi, John M Cunningham, David Filella, Daniel Hoody, David Hilden, Ming-Ju Hsieh, Yoon-Seon Lee, Daniel D Melley, Anna Munoa, Francesca Perego, Chin-Chung Shu, Chang Hwan Sohn, Jeffrey Spence, Lindsay Thurman, Cindy R Towns, John You, Luca Zocchi, Richard K Albert. Opioid Utilization and Perception of Pain Control in Hospitalized Patients:A Cross-Sectional Study of 11 Sites in 8 Countries. Journal of Hospital Medicine, 2019; (2019-07-24 Online First) DOI: 10.12788/jhm.3256
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