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Article

Self-Reported Practices and Emotions in Prescribing Opioids for Chronic Noncancer Pain: A Cross-Sectional Study of German Physicians

1
Department of Palliative Medicine, Universitätsmedizin Göttingen, 37075 Göttingen, Germany
2
Pain Clinic, Department of Anesthesiology, Universitätsmedizin Göttingen, 37075 Göttingen, Germany
3
Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany
4
Department of Primary Care, Phillips-Universität Marburg, 35043 Marburg, Germany
5
Center for Adaptive Rationality, Max-Planck-Institut für Bildungsforschung, 14195 Berlin, Germany
*
Author to whom correspondence should be addressed.
Academic Editors: Markus W. Hollmann, Casandra I. Montoro Aguilar, Carmen María Galvez Sánchez and Patrice Forget
J. Clin. Med. 2022, 11(9), 2506; https://doi.org/10.3390/jcm11092506
Received: 3 April 2022 / Revised: 23 April 2022 / Accepted: 25 April 2022 / Published: 29 April 2022
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
Background: The pressure on physicians when a patient seeks pain relief and their own desire to be self-effective may lead to the prescription of strong opioids for chronic noncancer pain (CNCP). This study, via physician self-reporting, aims to identify and measure (i) physician adherence to national opioid prescribing guidelines and (ii) physician emotions when a patient seeks a dosage increase of the opioid. Methods: Within a cross-sectional survey—conducted as part of a randomized controlled online intervention trial (ERONA)—600 German physicians were queried on their opioid prescribing behavior (choice and formulation of opioid, indications) for CNCP patients and their emotions to a case vignette describing a patient seeking an opioid dosage increase without signs of objective deterioration. Results: The prescription of strong opioids in this study was not always in accordance with current guidelines. When presented with a scenario in which a patient sought to have their opioid dose increased, some physicians reported negative feelings, such as either pressure (25%), helplessness (25%), anger (23%) or a combination. The risk of non-guideline-compliant prescribing behavior using the example of ultrafast-acting fentanyl for CNCP was increased when negative emotions were present (OR: 1.7; 95%-CI: 1.2–2.6; p = 0.007) or when sublingual buprenorphine was prescribed (OR: 15.4; 95%-CI: 10.1–23.3; p < 0.001). Conclusions: Physicians’ emotional self-awareness represents the first step to identify such direct reactions to patient requests and to ensure a responsible, guideline-based opioid prescription approach for the long-term well-being of the patient. View Full-Text
Keywords: chronic noncancer pain; WHO III opioids; prescription; guideline adherence chronic noncancer pain; WHO III opioids; prescription; guideline adherence
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    Doi: doi: 10.1016/j.pec.2021.10.002.
    Description: Questionnaire ERONA German and English (subproject) Study protocol ERONA
MDPI and ACS Style

Schulte, E.; Petzke, F.; Spies, C.; Denke, C.; Schäfer, M.; Donner-Banzhoff, N.; Hertwig, R.; Wegwarth, O. Self-Reported Practices and Emotions in Prescribing Opioids for Chronic Noncancer Pain: A Cross-Sectional Study of German Physicians. J. Clin. Med. 2022, 11, 2506. https://doi.org/10.3390/jcm11092506

AMA Style

Schulte E, Petzke F, Spies C, Denke C, Schäfer M, Donner-Banzhoff N, Hertwig R, Wegwarth O. Self-Reported Practices and Emotions in Prescribing Opioids for Chronic Noncancer Pain: A Cross-Sectional Study of German Physicians. Journal of Clinical Medicine. 2022; 11(9):2506. https://doi.org/10.3390/jcm11092506

Chicago/Turabian Style

Schulte, Erika, Frank Petzke, Claudia Spies, Claudia Denke, Michael Schäfer, Norbert Donner-Banzhoff, Ralph Hertwig, and Odette Wegwarth. 2022. "Self-Reported Practices and Emotions in Prescribing Opioids for Chronic Noncancer Pain: A Cross-Sectional Study of German Physicians" Journal of Clinical Medicine 11, no. 9: 2506. https://doi.org/10.3390/jcm11092506

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