Attitudes and practices of physician assistants in the state of Kansas with regards to opioid management in chronic non-malignant pain patients

Abstract

Acute and chronic pain are common conditions practitioners continually face in diagnosing and treating patients. The use of prescribing opioids in chronic non-malignant pain (CNMP) patients is controversial due to fear of legal issues and a lack of awareness of state guidelines for treatment. The purpose of this research was to investigate the attitudes and practices of Physician Assistants (PAs) in Kansas in the treatment of CNMP and their awareness of state guidelines for controlled substances.

Methods: A cross sectional, non-randomized survey study was administered to all licensed PAs (N=577) in the State of Kansas in 2005. The survey consisted of specific questions regarding attitudes toward opioid management, prescribing habits, and familiarity with the recommended guidelines of the State of Kansas.

Results: Slightly less than half of the PA’s in this study were aware of state guidelines for the use of controlled substances in CNMP and actively followed three of the five clinical documentation recommendations. Among the 177 PAs responding to the survey, only nine percent stated they would never prescribe an opioid for the use of CNMP. There was a significant relationship between awareness of state guidelines and clinical documentation of a history and physical, treatment, and informed consent.

Conclusion: Practitioners continue to be hesitant in prescribing opioids for CNMP due to concern for legal issues and fear of potential substance abuse in patients. This pilot study highlights the need for larger studies of primary clinicians and the potential of patient undertreatment of CNMP.