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Physicians' intention to prescribe hydrocodone combination products after rescheduling: A theory of reasoned action approach.
Res Social Adm Pharm. 2017 May - Jun; 13(3):503-512.RS

Abstract

BACKGROUND

The U.S. Drug Enforcement Administration (DEA) rescheduled hydrocodone combination products (HCPs) in an attempt to mitigate the prescription opioid epidemic. Many in the medical and pharmacy community expressed concerns of unintended consequences as a result of rescheduling.

OBJECTIVES

This study examined physicians' intentions to prescribe HCPs after rescheduling using the framework of the theory of reasoned action (TRA).

METHODS

A cover letter containing a link to the online questionnaire was sent to physicians of the Texas Medical Association who were likely to prescribe opioids. The questionnaire assessed physicians' intentions to prescribe HCPs after rescheduling. Predictor variables included attitude toward rescheduling, subjective norm toward HCP prescribing, and past prescribing behavior of schedule II prescriptions. All variables were measured on a 7-point, Likert-type scale. Intention to prescribe as a dependent variable was regressed over TRA variables and respondent characteristics.

RESULTS

A total of 1176 usable responses were obtained, yielding a response rate of 13.3%. Mean (M) age was 53.07 ± 11 and most respondents were male (70%) and Caucasian (75%). Physicians held a moderately positive intention to prescribe HCPs (M = 4.36 ± 2.08), held a moderately negative attitude towards rescheduling, M = 4.68 ± 1.51 (reverse coded). Subjective norm was moderately low, M = 3.06 ± 1.78, and past prescribing behavior M = 2.43 ± 1.21. The linear regression analysis indicated that attitude (β = 0.10; P = 0.006), subjective norm (β = 0.35; P < 0.0001) and past prescribing behavior (β = 0.59; P < 0.0001) were significant predictors of intention to prescribe HCPs after rescheduling.

CONCLUSIONS

TRA was shown to be a predictive model of physicians' intentions to prescribe HCPs after rescheduling. Overall, physicians held a moderately positive intention to prescribe HCPs. Past behavior concerning schedule II prescribing was found to be the most significant predictor of intention. Understanding the impact of federal rule changes on pain management care and patient satisfaction is necessary to determine whether this change has produced the intended consequences without harming patients in need of HCPs.

Authors+Show Affiliations

Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Texas Medical Center Campus, 1441 Moursund St, Houston, TX 77030, USA. Electronic address: mlflemi2@central.uh.edu.Department of Pain Medicine, Division of Anesthesiology and Critical Care, The University of Texas-MD Anderson Cancer Center, Houston, TX 77030, USA.Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Texas Medical Center Campus, 1441 Moursund St, Houston, TX 77030, USA.Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Texas Medical Center Campus, 1441 Moursund St, Houston, TX 77030, USA.Department of Pharmacy Practice and Translational Research, University of Houston, College of Pharmacy, Texas Medical Center Campus, 1441 Moursund St, Houston, TX 77030, USA.Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Texas Medical Center Campus, 1441 Moursund St, Houston, TX 77030, USA.Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Texas Medical Center Campus, 1441 Moursund St, Houston, TX 77030, USA.School of Nursing, University of Houston, 14000 University Blvd., Sugar Land, TX 77479, USA.The University of Texas-MD Anderson Cancer Center, Unit 1468, 1515 Holcombe Blvd., Houston, TX 77030, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27567741

Citation

Fleming, Marc L., et al. "Physicians' Intention to Prescribe Hydrocodone Combination Products After Rescheduling: a Theory of Reasoned Action Approach." Research in Social & Administrative Pharmacy : RSAP, vol. 13, no. 3, 2017, pp. 503-512.
Fleming ML, Driver L, Sansgiry SS, et al. Physicians' intention to prescribe hydrocodone combination products after rescheduling: A theory of reasoned action approach. Res Social Adm Pharm. 2017;13(3):503-512.
Fleming, M. L., Driver, L., Sansgiry, S. S., Abughosh, S. M., Wanat, M., Sawant, R. V., Ferries, E., Reeve, K., & Todd, K. H. (2017). Physicians' intention to prescribe hydrocodone combination products after rescheduling: A theory of reasoned action approach. Research in Social & Administrative Pharmacy : RSAP, 13(3), 503-512. https://doi.org/10.1016/j.sapharm.2016.07.001
Fleming ML, et al. Physicians' Intention to Prescribe Hydrocodone Combination Products After Rescheduling: a Theory of Reasoned Action Approach. Res Social Adm Pharm. 2017 May - Jun;13(3):503-512. PubMed PMID: 27567741.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physicians' intention to prescribe hydrocodone combination products after rescheduling: A theory of reasoned action approach. AU - Fleming,Marc L, AU - Driver,Larry, AU - Sansgiry,Sujit S, AU - Abughosh,Susan M, AU - Wanat,Matthew, AU - Sawant,Ruta V, AU - Ferries,Erin, AU - Reeve,Kathleen, AU - Todd,Knox H, Y1 - 2016/07/29/ PY - 2016/07/16/received PY - 2016/07/16/accepted PY - 2016/8/29/pubmed PY - 2017/10/31/medline PY - 2016/8/29/entrez KW - Hydrocodone KW - Opioid prescribing KW - Pain management KW - Prescription drug abuse KW - Rescheduling KW - Theory of reasoned action SP - 503 EP - 512 JF - Research in social & administrative pharmacy : RSAP JO - Res Social Adm Pharm VL - 13 IS - 3 N2 - BACKGROUND: The U.S. Drug Enforcement Administration (DEA) rescheduled hydrocodone combination products (HCPs) in an attempt to mitigate the prescription opioid epidemic. Many in the medical and pharmacy community expressed concerns of unintended consequences as a result of rescheduling. OBJECTIVES: This study examined physicians' intentions to prescribe HCPs after rescheduling using the framework of the theory of reasoned action (TRA). METHODS: A cover letter containing a link to the online questionnaire was sent to physicians of the Texas Medical Association who were likely to prescribe opioids. The questionnaire assessed physicians' intentions to prescribe HCPs after rescheduling. Predictor variables included attitude toward rescheduling, subjective norm toward HCP prescribing, and past prescribing behavior of schedule II prescriptions. All variables were measured on a 7-point, Likert-type scale. Intention to prescribe as a dependent variable was regressed over TRA variables and respondent characteristics. RESULTS: A total of 1176 usable responses were obtained, yielding a response rate of 13.3%. Mean (M) age was 53.07 ± 11 and most respondents were male (70%) and Caucasian (75%). Physicians held a moderately positive intention to prescribe HCPs (M = 4.36 ± 2.08), held a moderately negative attitude towards rescheduling, M = 4.68 ± 1.51 (reverse coded). Subjective norm was moderately low, M = 3.06 ± 1.78, and past prescribing behavior M = 2.43 ± 1.21. The linear regression analysis indicated that attitude (β = 0.10; P = 0.006), subjective norm (β = 0.35; P < 0.0001) and past prescribing behavior (β = 0.59; P < 0.0001) were significant predictors of intention to prescribe HCPs after rescheduling. CONCLUSIONS: TRA was shown to be a predictive model of physicians' intentions to prescribe HCPs after rescheduling. Overall, physicians held a moderately positive intention to prescribe HCPs. Past behavior concerning schedule II prescribing was found to be the most significant predictor of intention. Understanding the impact of federal rule changes on pain management care and patient satisfaction is necessary to determine whether this change has produced the intended consequences without harming patients in need of HCPs. SN - 1934-8150 UR - https://www.unboundmedicine.com/medline/citation/27567741/Physicians'_intention_to_prescribe_hydrocodone_combination_products_after_rescheduling:_A_theory_of_reasoned_action_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1551-7411(16)30228-5 DB - PRIME DP - Unbound Medicine ER -