Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

A mixed methods study of patient-provider communication about opioid analgesics.

Hughes HK, Korthuis PT, Saha S, Eggly S, Sharp V, Cohn J, Moore R, Beach MC. A mixed methods study of patient-provider communication about opioid analgesics. Patient education and counseling. 2015 Apr 1; 98(4):453-61.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

OBJECTIVE: To describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. METHODS: We audio-recorded 45 HIV providers and 423 patients in routine outpatient encounters at four sites across the country. Providers completed post-visit questionnaires assessing their attitudes toward patients. We identified discussions about opioid pain management and analyzed them qualitatively. We used logistic regression to assess the association between opioid discussion and providers' attitudes toward patients. RESULTS: 48 encounters (11% of the total sample) contained substantive discussion of opioid-related pain management. Most conversations were initiated by patients (n = 28, 58%) and ended by the providers (n = 36, 75%). Twelve encounters (25%) contained dialog suggesting a difference of opinion or conflict. Providers more often agreed than disagreed to give the prescription (50% vs. 23%), sometimes reluctantly; in 27% (n = 13) of encounters, no decision was made. Fewer than half of providers (n = 20, 42%) acknowledged the patient's experience of pain. Providers had a lower odds of positive regard for the patient (adjusted OR = 0.51, 95% CI: 0.27-0.95) when opioids were discussed. CONCLUSIONS: Pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients. PRACTICE IMPLICATIONS: Empathy and pain acknowledgment are tools that clinicians can use to facilitate productive discussions of pain management.





Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.