Primary care provider attitudes regarding physical therapists addressing opioid use and opioid misuse: a qualitative study

初级保健提供者对物理治疗师处理阿片类药物使用和滥用问题的态度:一项定性研究

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Abstract

IMPORTANCE: Primary care providers (PCPs) manage musculoskeletal pain and may prescribe opioids for their patients, presenting risk for opioid misuse. Physical therapists are well-positioned to collaborate with PCPs in identifying and mitigating opioid risk and misuse for patients that PCPs and physical therapists co-manage. How PCPs view such collaboration is unclear. OBJECTIVE: The objective of this study was to explore PCPs' attitudes regarding physical therapists' role in identifying and mitigating opioid risk and opioid misuse. DESIGN: This was a qualitative study using rapid content analysis and it was the first phase in a sequential exploratory mixed-methods investigation. SETTING AND PARTICIPANTS: Semi-structured interviews were conducted with 22 PCPs in Utah. PCPs were invited to participate if they were listed by the Utah Division of Professional Licensure as having an active license to practice in Utah. PCPs were eligible to participate if they (1) referred a patient to outpatient physical therapy within the past 6 months and (2) prescribed an opioid within the past 6 months. Interviews were conducted between May 6, 2024, and August 9, 2024, and were audio recorded and transcribed. MAIN OUTCOME: The main outcomes were qualitative themes reported by the PCPs surrounding their attitudes toward collaborating with physical therapists on patients taking prescription opioid medication for pain. RESULTS: Twenty-two PCPs were interviewed, which included 7 (31.8%) physicians, 6 (27.3%) nurse practitioners, and 9 (40.9%) physician assistants. Mean years of clinical experience was 13.9 (SD = 9.1) with 12 (56.0%) participants identifying as female and 20 (90.1%) identifying as White. The themes identified were (1) physical therapist's involvement in opioid management can help patients, (2) communication between physical therapists and PCPs regarding opioids is important, (3) physical therapists should educate their patients about the risks of opioid use, and (4) physical therapists should refer their patients with suspected opioid misuse for further management. CONCLUSION AND RELEVANCE: PCPs favorably regarded physical therapists' involvement in identifying and mitigating opioid risk and misuse among co-managed patients.

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