Abstract
Background: Increased availability of prescription opioids has caused serious problems with misuse, abuse, and increased rates of morbidity and mortality. In response, Washington State enacted a law to regulate pain management and opioid prescribing practices.
Objectives: The purpose of this research was to investigate healthcare professionals' practices for the care of individuals with chronic noncancer pain (CNP) who received opioid therapy before the enactment of the Washington State law.
Methods: This descriptive study used a tailored design survey protocol with a 23-item questionnaire and stratified random sample of 1618 Washington State healthcare professionals. Topic areas assessed included prescribing patterns; use of best practices; consultation access; and provider education, satisfaction, and competence in prescribing opioids.
Results: Only 41% of the respondents provided care for patients with CNP. Of these, nearly all (96%) managed patients with prescription opioids. Most reported "always" obtaining, evaluating, and documenting the patient's health history (86%); reviewing the patient's history for substance abuse (77.8%); and conducting ongoing interviews (57.3%). Sixty percent of the respondents self-rated being not at all, somewhat, or moderately competent to prescribe opioids. Only 8.5% reported being very or extremely satisfied working with patients with CNP.
Conclusions: The enactment of Washington State's pain management law mandates all providers to adopt management and prescribing practices for patients with CNP receiving opioid medications. This study determined that these practices were not universally adopted before the law. Evaluation of the effect of this law is essential to determine if it can serve as a model for other states.
Perspective: In 2010, Washington State enacted legislation on the management of CNP. The purpose of this study was to assess clinical practice among health professionals providing care to patients with CNP before implementation of the law and to discuss the potential impact of the regulation.