Blog | Monday, July 2, 2012

QD: News Every Day--Internists mixed in their views on managing opioids

Nearly 60% of internists say they're confident that they can manage patients on opioids, but 40% either aren't confident or don't do it at all, a survey showed.

Opiate management has become a topic to dread among some internists. It's difficult to interact with patients in pain, and the risks of abuse can damage patients and careers alike.

Attend any Internal Medicine meeting and you'll find a few sessions are always packed to standing room only capacity, and sessions on opioid management are among them.

One such session led to ACP Internist's story on the topic, which offered clear-cut and easy guidelines to help internists achieve the best outcomes.

An accompanying poll asked readers how confident they were in their ability to manage patients who are on opiates. Responses were:
Extremely confident (24.49%)
Somewhat confident (34.69%)
Not very confident (18.37%)
Not confident at all (10.2%)
I don't manage patients on opiates (12.24%)

Pearls for safe and efficient opioid management include:
--set clear upper limits on dosing
--be wary when patients request more and more medications
--practice the patient encounter and have a prepared sentence in mind for patients who seek more than they are comfortable prescribing
--document repeated reviews of expectations, such as no early refills

ACP Internist continues its readership poll in July by addressing how internists can work with another difficult group of patients: baby boomers. Their high expectations can be dashed as they encounter the normal effects of age, and their rising numbers will require effort to manage in a primary care setting, since so few physicians specialize in geriatrics.

We ask: "As the baby boomer population reaches retirement age, approximately what percent of the care you provide will be geriatrics?" Take our poll and let us know how your practice will change in upcoming years.