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Res Social Adm Pharm. 2018 Aug 10. pii: S1551-7411(18)30302-4. doi: 10.1016/j.sapharm.2018.08.006. [Epub ahead of print]

Communication between pharmacists and primary care physicians in the midst of a U.S. opioid crisis.

Author information

1
University of Arkansas for Medical Sciences, 4301 West Markham St., #522-4, Little Rock, AR, 72205-7199, United States; Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR, 72114, United States. Electronic address: currangeoffreym@uams.edu.
2
University of Kentucky, College of Pharmacy, 789 South Limestone Street, Lexington, KY, 40536, United States.
3
University of Arkansas for Medical Sciences, 4301 West Markham St., #522-4, Little Rock, AR, 72205-7199, United States.
4
University of Arkansas for Medical Sciences, 4301 West Markham St., #522-4, Little Rock, AR, 72205-7199, United States; Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR, 72114, United States.
5
Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101-1466, United States.
6
RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, United States.

Abstract

BACKGROUND:

Effective communication between prescribers of opioids and community pharmacists can contribute to maximizing appropriate pain management and reducing opioid misuse and diversion. While much of the education and training available on reducing opioid misuse and diversion stresses the importance of interprofessional communication between prescribers and pharmacists, few studies have been explored those communication patterns directly.

OBJECTIVE:

The objectives of this manuscript are to present and explore key emergent themes from a qualitative study around the nature, frequency, and content of communication between primary care physicians (PCPs) and pharmacists focusing on opioids.

METHODS:

Interviews were conducted with 48 PCPs and 60 community pharmacists across four states in the U.S.: Washington, Idaho, Kentucky and Arkansas.

RESULTS:

Convergent results from both samples indicated that the content of communication usually centers on questions of dosing, timing of the prescription, and/or evidence of potential misuse/diversion. When communication was focused on relaying information about a patient and/or clarifying questions around the prescription, it appeared positive for both parties. Results also indicated that close physical proximity between PCPs and dispensing pharmacists contributed to more positive and useful communication, especially when the clinics and pharmacies were part of the same healthcare system. Many pharmacists reported hesitancy in "questioning" a physician's judgement, which appeared related to commonly held beliefs of both pharmacists and physicians about the respective roles of each in providing patient care. Pharmacists reported difficulty in reaching PCPs for discussion, while PCPs reported it was easy to reach pharmacists.

CONCLUSIONS:

Physician and pharmacist communication around opioids can be mutually beneficial. When prescribers and pharmacists are co-located, higher levels of trust and teamwork are reported, which in turn seems to be related to more open and positive communication. Additional research is needed to identify interventions to increase mutually-valued communication that improves the quality of decision-making around opioids.

KEYWORDS:

Interprofessional communication; Opioids; Qualitative research, United States

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