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. 2018 May;149(5):353-362.
doi: 10.1016/j.adaj.2017.11.031. Epub 2018 Mar 15.

Opioid prescribing and risk mitigation implementation in the management of acute pain: Results from The National Dental Practice-Based Research Network

Jenna L McCauley, Renata S Leite, Valeria V Gordan, Roger B Fillingim, Gregg H Gilbert, Cyril Meyerowitz, David Cochran, D Brad Rindal, Kathleen T Brady; National Dental Practice-Based Research Network Collaborative Group

Opioid prescribing and risk mitigation implementation in the management of acute pain: Results from The National Dental Practice-Based Research Network

Jenna L McCauley et al. J Am Dent Assoc. 2018 May.

Abstract

Background: Minimal information exists regarding the consistency and correlates of dentists' implementation of risk mitigation strategies when prescribing opioids, including risk screening, prescription drug monitoring program (PDMP) use, and patient education.

Methods: The authors conducted a Web-based, cross-sectional survey among practicing dentist members of The National Dental Practice-Based Research Network. The authors used the survey to assess pain management prescribing practices and risk mitigation implementation. The authors linked survey data with network enrollment questionnaire data to include practitioner demographic and practice characteristics.

Results: A total of 822 dentists completed the survey. A minority of dentists reported prescribing opioids only (11%) or opioids in combination with a recommendation for nonsteroidal anti-inflammatory drugs or acetaminophen (18%) to one-half or more of their patients needing management of acute pain. Higher levels of opioid prescribing were associated significantly with less consistent implementation of PDMP use (r = -0.20) and patient education (r = -0.11).

Conclusions: Most dentists reported infrequent PDMP use and counseling patients regarding risks, storage, and disposal of opioids. Higher frequency of opioid prescribing was associated with less consistent risk mitigation implementation.

Practical implications: When opioid prescribing is indicated, risk of misuse and diversion may be mitigated by consistent PDMP use and provision of patient education. Dental education in this arena is needed.

Keywords: Pain; drug; patient education; prescriptions.

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