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Prescription Patterns of Pain Medicine Physicians
Author(s) -
Benzon Honorio T.,
Kendall Mark C.,
Katz Jeffrey A.,
Benzon Hubert A.,
Malik Khalid,
Cox Paul,
Dean Kathryn,
Avram Michael J.
Publication year - 2013
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12011
Subject(s) - medicine , codeine , acetaminophen , medical prescription , opioid , methadone , drug , prescription drug misuse , anesthesia , emergency medicine , psychiatry , morphine , pharmacology , opioid use disorder , receptor
Objectives Our study surveyed physician members of 3 A merican pain societies to determine prescription patterns and whether these practices reflect current expert opinion. Methods We sent 3 mailings to 2938 physicians from J anuary 2010 to J anuary 2011. The questionnaire contained 49 questions on topics related to opioids, antidepressants, anticonvulsants, and preferences for the different pain syndromes. Results A total of 474 physicians responded, representing a 16% return. Seventy‐two percent ask patients to sign an opioid agreement, 59% order random urine drug testing, 13% wait until the dose of methadone is between 100 and 150 mg before converting the drug to another opioid, and 85% do not think there is a maximum dose of opioids with respect to driving. Most responders prescribe codeine to C aucasians and A sians. While 42% stated that the maximum daily dose of acetaminophen is 3000 mg, 75% would decrease the dose in patients who are moderate or heavy drinkers. Fifty‐four percent do not order an ECG at all when prescribing tricyclic antidepressants. Conclusions The responses pertaining to opioid agreements, urine drug testing, acetaminophen, and treatment for neuropathic pain are reassuring in that they prevent misuse and abuse of opioids, prevent acetaminophen‐induced hepatotoxicity, and reflect evidence‐based treatments. However, we identified gaps in knowledge, including the prescription of codeine in certain populations and the use of electrocardiogram in patients on antidepressants. Further education of physicians who treat chronic pain pharmacologically is warranted.