J Am Dent Assoc. 2018 Mar 14. pii: S0002-8177(17)31109-1. doi: 10.1016/j.adaj.2017.11.031. [Epub ahead of print]
Abstract
BACKGROUND:
Minimal
information exists regarding the consistency and correlates of
dentists' implementation of risk mitigation strategies when prescribing
opioids, including risk screening, prescription drug monitoring program
(PDMP) use, and patient education.
METHODS:
The
authors conducted a Web-based, cross-sectional survey among practicing
dentist members of The National Dental Practice-Based Research Network.
The authors used the survey to assess pain management prescribing
practices and risk mitigation implementation. The authors linked survey
data with network enrollment questionnaire data to include practitioner
demographic and practice characteristics.
RESULTS:
A
total of 822 dentists completed the survey. A minority of dentists
reported prescribing opioids only (11%) or opioids in combination with a
recommendation for nonsteroidal anti-inflammatory drugs or
acetaminophen (18%) to one-half or more of their patients needing
management of acute pain. Higher levels of opioid prescribing were
associated significantly with less consistent implementation of PDMP use
(r = -0.20) and patient education (r = -0.11).
CONCLUSIONS:
Most
dentists reported infrequent PDMP use and counseling patients regarding
risks, storage, and disposal of opioids. Higher frequency of opioid
prescribing was associated with less consistent risk mitigation
implementation.
PRACTICAL IMPLICATIONS:
When
opioid prescribing is indicated, risk of misuse and diversion may be
mitigated by consistent PDMP use and provision of patient education.
Dental education in this arena is needed.
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