{
  "abstract": "Background and Importance Opioid prescriptions increased significantly between 2008 and 2017, raising concerns about misuse and leading to the development of prescribing guidelines and awareness efforts. Previous studies mainly explored opioid prescribing for chronic non-malignant pain in primary care. However, less is known about the beliefs, practices and knowledge of secondary care clinicians.Aim and Objectives This study aimed to provide an overview of the perspectives among secondary care clinicians, distinguishing between different pain types and comparing perspectives with those in primary care.Material and Methods A prospective quantitative study was conducted at a large teaching hospital, using a self-developed, anonymous questionnaire, based on the Health Belief Model and available literature, to assess clinicians’ beliefs, practices, and knowledge regarding opioid prescribing and (mis)use. The 38-item questionnaire compromised three domains and distinguished between three types of pain: acute and post-operative pain (APOP), chronic non-malignant pain (CNMP), and cancer pain (CP). In addition, an indirect comparison was made between primary and secondary care prescribers with regard to CNMP. Data were analysed descriptively.Results 168 of 668 of the invited clinicians completed the questionnaire for at least one type of pain (response rate 25.1%). Most responses concerned APOP (n=133), followed by CNMP (n=49) and CP (n=30). Clinicians managing CNMP reported less confidence and greater caution when prescribing opioids compared to those treating APOP or CP. Clinicians treating CP perceived fewer barriers and greater benefits of opioids, whereas those treating APOP mainly considered opioids primarily for short-term pain management. Across all pain types, 70.5% of clinicians reported low confidence in recognising symptoms of misuse. Clear agreements on opioid refills within specialties (26%) or between specialties and general practitioners (GPs) (18%) were rare. Finally, GPs reported greater confidence in their skills in prescribing opioids for CNMP than secondary care clinicians (61.2% vs. 34.7%).Conclusion and Relevance Clinicians’ beliefs regarding opioid prescribing vary by pain type, with those treating CNMP expressing more concerns and less confidence than those managing APOP or CP. Recognising opioid misuse is a challenge for all clinicians. GPs seem more confident in managing CNMP than clinicians in secondary care. Finally, there seems to be room for harmonisation of responsibilities regarding opioid refills.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Utrecht University, Department of Pharmaceutical Sciences, Utrecht, The Netherlands"
      ],
      "name": "M Smit"
    },
    {
      "affiliations": [
        "Elisabeth Tweesteden Hospital, Department of Clinical Pharmacy, Tilburg, The Netherlands"
      ],
      "name": "M Jansen"
    },
    {
      "affiliations": [
        "Elisabeth Tweesteden Hospital, Department of Clinical Pharmacy, Tilburg, The Netherlands"
      ],
      "name": "B Maat"
    },
    {
      "affiliations": [
        "Elisabeth Tweesteden Hospital, Department of Clinical Pharmacy, Tilburg, The Netherlands"
      ],
      "name": "T Jaspers"
    },
    {
      "affiliations": [
        "Elisabeth Tweesteden Hospital, Department of Orthopaedic Surgery, Tilburg, The Netherlands"
      ],
      "name": "R Geuze"
    },
    {
      "affiliations": [
        "Elisabeth Tweesteden Hospital, Department of Anaesthesiology, Tilburg, The Netherlands"
      ],
      "name": "D Jansen"
    },
    {
      "affiliations": [
        "Elisabeth Tweesteden Hospital, Department of Vascular Surgery, Tilburg, The Netherlands"
      ],
      "name": "K Hees Van"
    }
  ],
  "title": "5PSQ-140 Beliefs, practices and knowledge regarding the use and risks of opioids among clinicians",
  "uid": "8144fbb8-c838-5bbb-8dac-f6542a08d5f4"
}