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. 2020 Jun;14(6):199-203.
doi: 10.5489/cuaj.6221.

Analgesic prescribing habits and patterns of Canadian chief urology residents: A national survey

Ali Dergham  1 , Greg Hosier  2 , Melanie Jaeger  3 , J Curtis Nickel  2 , D Robert Siemens  2 , Thomas McGregor  2
Affiliations

Analgesic prescribing habits and patterns of Canadian chief urology residents: A national survey

Ali Dergham et al. Can Urol Assoc J. 2020 Jun.

Abstract

Introduction: Prior studies have identified significant knowledge gaps in acute and chronic pain management among graduating urology residents as of five years ago. Since then, there has been increasing awareness of the impact of excessive opioid prescribing on long-term narcotic use and development of adverse narcotic-related events. However, it is unclear whether the attitudes and experience of graduating urology residents have changed. We set out to evaluate the attitudes and experience of graduating urology residents in prescribing opioid/non-opioid analgesia for acute (AP), chronic non-cancer (CnC), and chronic cancer (CC) pain.

Methods: Graduating urology residents were surveyed at a review course in 2018. The survey consisted of open-ended and close-ended five-point Likert scale questions. Descriptive statistics, Mann-Whitney U-test, and Student's t-test were performed.

Results: A total of 32 postgraduate year-5 (PGY5) urology residents completed our survey (92% response rate). The vast majority agreed that formal training in managing AP/CnC/CC is valuable (91/78/81%). Most find their training in CnC/CC management to be inadequate and are unaware of any opioid prescribing guidelines; 66% never counsel patients on how to dispose of excess opioids. In general, 88% are comfortable prescribing opioids, whereas most are very uncomfortable prescribing cannabis or antidepressants (100% and 78%, respectively). Residents reported the acute pain service as the highest-rated resource for information, and dedicated textbooks the least.

Conclusions: This survey demonstrated that experience in pain management remains variable among urology residents. Knowledge gaps remain, particularly in the management of CC/CnC pain.

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Conflict of interest statement

Competing interests: Dr. Nickel has been a consultant for Astellas, Auxillium, Eli Lilly, Farr Labs, Ferring, GSK, Pfizer, Redleaf Pharma, Taris Biomedical, Tribute, and Trillium Therapeutics; a lecturer for Astellas and Eli Lilly; and has participated in clinical trials supported by Eli Lilly, GSK, J&J, Pfizer, and Taris Biomedical. Dr. Siemens has participated in educational talks supported by Ferring; and has participated in clinical trials supported by Astellas, Janssen, and Pfizer. The remaining authors report no competing personal or financial interests related to this work.

Figures

Fig. 1
Fig. 1
Reported overall comfort and experience in managing acute pain, chronic non-cancer pain, and chronic cancer.
Fig. 2
Fig. 2
Educational resources used. Box and whisker plot (mean, 95% confidence limit) of ranking scores.
Fig. 3
Fig. 3
Reported comfort level prescribing different drug modalities. NSAID: non-steroidal anti-inflammatory drug.
Fig. 4
Fig. 4
Breakdown of hand-filled prescriptions.
Fig. 5
Fig. 5
Amount of opioid dispensed per prescription.
See this image and copyright information in PMC

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