Karen J. Sherman
Patients receiving chronic opioid therapy typically reported favorable perceptions of doctor-patient trust on the subject of long-term opioid therapy management, according to findings recently published in the Journal of the American Board of Family Medicine.
“Because risk reduction initiatives may call for reductions in opioid dose for [chronic opioid therapy] patients, they might have adverse effects on already challenging doctor-patient relationships. Risk reduction initiatives also call for closer monitoring of [chronic opioid therapy] patients, including more consistent use of urine drug screening, which may also raise questions for some [chronic opioid therapy] patients,” Karen J. Sherman, PhD, of Kaiser Permanente Washington Health Research Institute, and colleagues wrote.
“There is little information on how these initiatives impact the level of trust in the patient-doctor relationship among [chronic opioid therapy] users,” they added.
Researchers conducted telephone surveys with 1,588 patients with chronic pain receiving chronic opioid therapy about their trust in their prescribing doctor. Of those, 935 were from intervention settings that implemented opioid dose reduction and performed closer patient monitoring. The other patients were in settings that did not implement these initiatives and served as the control group.
Sherman and colleagues found 82.2% of all the patients said they trusted their doctor’s judgment. Specifically, there was less agreement among patients in the intervention clinics (77.9%) vs. the control clinics (86.3%). The control clinics also had more patients believing their physician trusted them in how they managed their opioid pain medications (91.1% vs. 86.2%), and 21.8% of patients at the control clinics worried their doctors would stop prescribing opioid pain medicine vs. 29.3% at the intervention clinics.
“This is the first survey on the topic of patient’s perceptions of trust in the context of the doctor-patient relationship around chronic opioid therapy,” Sherman told Healio Family Medicine.
Researchers acknowledged the findings may not be uniform across the entire population, and suggested future studies look at doctor-patient trust in the less educated, more disadvantaged, younger and minority patients, who might have different experiences. – by Janel Miller
Sherman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.