Preliminary Interview Study on the Opioid Prescription Decision Making Process

• Published in: Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare Vol. 9; no. 1; pp. 234 - 237
• Main Authors: Wang, Xiaomei, Roth, Emilie M., Kim, Tracy, Arora, Jessica, Franklin, Ella S., Hettinger, Aaron Z., Bisantz, Ann M.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.09.2020
• ISSN: 2327-8595; 2327-8595
• DOI: 10.1177/2327857920091061

To date, studies have found scattered and inconsistent use of existing opioid prescription support tools, such as Prescription Drug Monitoring Systems (PDMPs) and guidelines, and little research has been done to identify barriers for adopting them and better ways to support clinician decision making. This pilot study aims to better understand the flow, resources used, and challenges faced when prescribing opioid medications. The study will help shape research questions for a larger study geared towards informing future decision aid designs and considerations for clinicians in the emergency department (ED). Semi-structured interviews were conducted with a total of six emergency medicine physicians and nurses using an abbreviated variant of the Critical Decision Method. Discussions were focused around how participants made their decisions and what was difficult about them, in addition to whether current aids and tools are helpful. Common themes were identified from free-text notes in the following categories: cognitive and communication challenges, challenges with existing tools and databases, and decision-making strategies. Nurse responses were most commonly related to gaps in communication between physicians and patients and ensuring patient satisfaction. Physicians most commonly reported challenges with existing tools. While existing resources were said to be very helpful, several improvements were suggested by each group. By understanding these types of challenges and dynamics between physicians and nurses in the ED, we can better identify ways to improve the design of opioid prescription decision-making aids in the future.