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Prescribers' perceptions on the impact of hydrocodone rescheduling on geriatric pain management: A qualitative study.
J Opioid Manag. 2018 Sep/Oct; 14(5):317-326.JO

Abstract

OBJECTIVE

To qualitatively assess prescribers) perceptions regarding the consequences associated with hydrocodone rescheduling among geriatric patients being discharged from inpatient settings.

DESIGN

This was a cross-sectional study.

SETTING

Two focus groups were conducted by a trained facilitator in a metropolitan academic medical center in January 2016.

PARTICIPANTS

Prescribers who manage noncancer pain for geriatric patients were recruited. Focus groups were recorded, transcribed, and then analyzed using ATLAS.ti Qualitative Data Analysis software. Codes were derived from six primary research questions and results were summarized into key themes regarding the impact of rescheduling.

MAIN OUTCOME MEASURES

Prescribers) perceptions regarding hydrocodone rescheduling.

RESULTS

Prescribers mentioned that they review the prescription monitoring program (PMP) more often before prescribing opioids after rescheduling. They expressed concern regarding the required special serialized prescription forms needed to issue schedule II prescriptions. This led to substituting hydrocodone with potentially less effective pain medications, the inability to issue refills on hydrocodone prescriptions, and an ethical concern over prescribing hydrocodone to patients not under their direct care. Additionally, rescheduling has affected the coordination of care upon discharge, as patients moving to long-term care or skilled nursing facilities may not have adequate pain management when transferred.

CONCLUSIONS

The majority of physicians felt rescheduling negatively impacted both practical and ethical aspects of patient care related to pain management after discharge. Rescheduling has changed physicians) hydrocodone prescribing patterns, leading to more caution when prescribing hydrocodone and greater use of the PMP. Future studies should assess geriatric patients) satisfaction and quality of life regarding pain management since hydrocodone was rescheduled.

Authors+Show Affiliations

Clinical Assistant Professor of Pharmacy Practice, Assistant Department Chair, Pharmacy Practice and Translational Research, Clinical Specialist in Geriatrics, Houston Methodist Hospital, Department of Pharmacy Practice and Translational Research, University of Houston, Houston, Texas.Assistant Professor of Pharmaceutical Health Outcomes and Policy, Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building 2, Houston, Texas.Graduate Student, Pharmaceutical Health Outcomes and Policy, Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building 2, Houston, Texas.Graduate Student, Pharmaceutical Health Outcomes and Policy, Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building 2, Houston, Texas.Graduate Student, Pharmaceutical Health Outcomes and Policy, Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building 2, Houston, Texas.Graduate Student, Pharmaceutical Health Outcomes and Policy, Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building 2, Houston, Texas.Assistant Professor, Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, Texas.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30387855

Citation

Fernandez, Julianna, et al. "Prescribers' Perceptions On the Impact of Hydrocodone Rescheduling On Geriatric Pain Management: a Qualitative Study." Journal of Opioid Management, vol. 14, no. 5, 2018, pp. 317-326.
Fernandez J, Thornton JD, Rege S, et al. Prescribers' perceptions on the impact of hydrocodone rescheduling on geriatric pain management: A qualitative study. J Opioid Manag. 2018;14(5):317-326.
Fernandez, J., Thornton, J. D., Rege, S., Lewing, B., Bapat, S., Xu, Q., & Fleming, M. L. (2018). Prescribers' perceptions on the impact of hydrocodone rescheduling on geriatric pain management: A qualitative study. Journal of Opioid Management, 14(5), 317-326. https://doi.org/10.5055/jom.2018.0464
Fernandez J, et al. Prescribers' Perceptions On the Impact of Hydrocodone Rescheduling On Geriatric Pain Management: a Qualitative Study. J Opioid Manag. 2018 Sep/Oct;14(5):317-326. PubMed PMID: 30387855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prescribers' perceptions on the impact of hydrocodone rescheduling on geriatric pain management: A qualitative study. AU - Fernandez,Julianna, AU - Thornton,James Douglas, AU - Rege,Sanika, AU - Lewing,Benjamin, AU - Bapat,Shweta, AU - Xu,Qingqing, AU - Fleming,Marc L, PY - 2018/11/3/entrez PY - 2018/11/6/pubmed PY - 2019/3/7/medline SP - 317 EP - 326 JF - Journal of opioid management JO - J Opioid Manag VL - 14 IS - 5 N2 - OBJECTIVE: To qualitatively assess prescribers) perceptions regarding the consequences associated with hydrocodone rescheduling among geriatric patients being discharged from inpatient settings. DESIGN: This was a cross-sectional study. SETTING: Two focus groups were conducted by a trained facilitator in a metropolitan academic medical center in January 2016. PARTICIPANTS: Prescribers who manage noncancer pain for geriatric patients were recruited. Focus groups were recorded, transcribed, and then analyzed using ATLAS.ti Qualitative Data Analysis software. Codes were derived from six primary research questions and results were summarized into key themes regarding the impact of rescheduling. MAIN OUTCOME MEASURES: Prescribers) perceptions regarding hydrocodone rescheduling. RESULTS: Prescribers mentioned that they review the prescription monitoring program (PMP) more often before prescribing opioids after rescheduling. They expressed concern regarding the required special serialized prescription forms needed to issue schedule II prescriptions. This led to substituting hydrocodone with potentially less effective pain medications, the inability to issue refills on hydrocodone prescriptions, and an ethical concern over prescribing hydrocodone to patients not under their direct care. Additionally, rescheduling has affected the coordination of care upon discharge, as patients moving to long-term care or skilled nursing facilities may not have adequate pain management when transferred. CONCLUSIONS: The majority of physicians felt rescheduling negatively impacted both practical and ethical aspects of patient care related to pain management after discharge. Rescheduling has changed physicians) hydrocodone prescribing patterns, leading to more caution when prescribing hydrocodone and greater use of the PMP. Future studies should assess geriatric patients) satisfaction and quality of life regarding pain management since hydrocodone was rescheduled. SN - 1551-7489 UR - https://www.unboundmedicine.com/medline/citation/30387855/Prescribers'_perceptions_on_the_impact_of_hydrocodone_rescheduling_on_geriatric_pain_management:_A_qualitative_study_ L2 - https://medlineplus.gov/nondrugpainmanagement.html DB - PRIME DP - Unbound Medicine ER -