• Karen J Sherman, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Michael Parchman, Ryan N Hansen, Manu Thakral, Evette J Ludman, Sascha Dublin, and Von KorffMichaelMFrom Kaiser Permanente Washington Health Research Institute, Seattle, WA (KJS, RLW, KS, SMS, MP, RNH, MT, EJL, SD, MVK); Department of Epidemiology, University of Washington, Seattle (KJS, SD); Department of Biostatistics, University of W.
• From Kaiser Permanente Washington Health Research Institute, Seattle, WA (KJS, RLW, KS, SMS, MP, RNH, MT, EJL, SD, MVK); Department of Epidemiology, University of Washington, Seattle (KJS, SD); Department of Biostatistics, University of Washington, Seattle (SMS); Department of Psychosocial and Community Health, School of Nursing, University of Washington, Seattle (MT); Departments of Pharmacy and Health Services, University of Washington, Seattle (RNH). sherman.k@ghc.org.
• J Am Board Fam Med. 2018 Jul 1; 31 (4): 578-587.

ObjectiveThis analysis examined patients' perceptions about trust within the doctor-patient relationship related to managing opioid pain medications. We compared perceptions among chronic opioid therapy (COT) patients who were and were not exposed to opioid risk reduction initiatives.MethodsBetween 2014 and 2016, we surveyed 1588 adults with chronic pain receiving COT about their trust in their prescribing doctor, their perceptions of their doctor's trust in them, their concerns about opioid prescribing, and their knowledge of opioid safety concerns. The population included adults receiving care in intervention settings that implemented opioid risk reduction initiatives and control settings with similar COT patients that did not.ResultsOverall, 82.2% of COT patients said they trusted their doctor's judgment, with more agreement among patients in the control clinics (86.3%; n = 653) than in the intervention clinics (77.9%; n = 935; P = .002). Similarly, slightly more patients in the control clinics believed their physician trusted how they managed their opioid pain medicines (91.1%) compared with the intervention clinics (86.2%; P = .002). The percent who worried that their doctor would stop prescribing opioid pain medicine was 29.3% in intervention clinics and 21.8% in control clinics (P = .007).ConclusionsAlthough COT patients typically reported favorable perceptions of doctor-patient trust in managing opioid pain medicines, implementation of opioid risk reduction initiatives may have reduced levels of trust for a minority of COT patients. This suggests that it may be possible to implement opioid risk-reduction initiatives while sustaining high levels of doctor-patient trust for most COT patients.© Copyright 2018 by the American Board of Family Medicine.

27 keywords...

hide…