Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;68(3):e28786.
doi: 10.1002/pbc.28786. Epub 2020 Nov 23.

Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows

Rebecca E MacDonell-Yilmaz  1 , Anarina Murillo  2   3 , Cia Panicker  2 , Jennifer G Welch  1
Affiliations

Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows

Rebecca E MacDonell-Yilmaz et al. Pediatr Blood Cancer. 2021 Mar.

Abstract

Background: Deficits in knowledge and comfort related to pain management have been demonstrated in adult hematology/oncology fellows. No such evaluation has been undertaken in pediatric hematology/oncology (PHO) trainees.

Procedure: An IRB-approved survey was administered to PHO fellows throughout the United States (US) to assess comfort with opioid dosing, attitudes related to the use of opioids, and knowledge of basic concepts including weight-based dosing, incomplete cross-tolerance, and management of side effects.

Results: Email addresses were obtained for 132 fellows from 37 programs. Seventy-eight (59%) fellows participated. No significant difference was demonstrated between training level and comfort with dosing opioids in an opioid-naive patient, though a smaller proportion of first-year fellows (65%) reported comfort compared to more senior fellows (85.2% of second-year fellows, 80.6% of third- and fourth-year fellows). First-year fellows correctly answered a mean of 5.05 ± 0.43 out of 10 objective knowledge questions; second-year fellows answered 5.74 ± 0.35 correctly, and third- and fourth-year fellows 5.58 ± 0.30. The majority of respondents chose an appropriate dose of intravenous morphine based on weight (92%), and identified a low-dose naloxone drip as an appropriate intervention for opioid-induced pruritis (91%). However, the remainder of the questions had a correct response rate of 15-68%.

Conclusion: This study characterizes PHO fellows' knowledge and comfort with prescribing opioids. Despite high levels of reported comfort, PHO fellows in all levels of training demonstrated knowledge gaps. PHO fellows may benefit from further education in pain management.

Keywords: pain; pain medicine; palliative care; pediatric hematology/oncology; support care.

PubMed Disclaimer

References

REFERENCES

    1. Sisk BA, Feudtner C, Bluebond-Langner M, Sourkes B, Hinds PS, Wolfe J. Response to suffering of the seriously ill child: a history of palliative care for children. Pediatrics. 2020;145(1):e20191741.
    1. Wolfe J, Grier HE, Klar N, et al. Symptoms and suffering at the end of life in children with cancer. N Engl J Med. 2000;342(5):326-333.
    1. Ferrell BR, Temel JS, Temin S, et al. Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2017;35(1):96-112.
    1. Kaasa S, Loge JH. Early integration of palliative care-new evidence and old questions. Lancet Oncol. 2018;19(3):280-281.
    1. Section on Hospice and Palliative Medicine and Committee on Hospital Care. Pediatric Palliative Care and Hospice Care Commitments, Guidelines, and Recommendations. Pediatrics. 2013;132(5):966-972.

Publication types

Substances

LinkOut - more resources