Table 2.
Obstetric Physicians’ Interview Questions, Themes, and Responses
| Theme | Response*† |
|---|---|
|
| |
| Question 1: What clinical recommendations do you use to guide your decision process for writing a prescription? | |
| No guidelines, relied on clinical insight | 27 (71) |
| Medical training experience | 12 (32) |
| Evidence from literature | 6 (16) |
| Patient history or check prescription drug monitoring program | 5 (13) |
| No guidelines | 3 (8) |
| Urine drug screen | 1 (3) |
| Used guidelines | 10 (26) |
| ACOG | 8 (21) |
| CDC | 2 (5) |
| Did not answer appropriately | 1 (3) |
| Question 2: How familiar are you with the obstetrics and gynecology opioid prescribing guidelines recently developed by the Commonwealth of Pennsylvania? | |
| Not familiar | 33 (87) |
| Familiar | 5 (13) |
| Question 3: These guidelines recommend use of the safest drug available (eg, acetaminophen) for most mild to moderate pain, and suggest that opioids can be used for 3–5 days after cesarean birth or severe perineal trauma. What are your thoughts about these recommendations? | |
| In line with current practice | 34 (89) |
| Recommendations are strict | 4 (11) |
| Question 4: What patient screening tools do you administer to assess a woman’s readiness to receive an opioid prescription after delivery? | |
| No standardized tool | 35 (92) |
| No routine use of screening tool | 13 (34) |
| No screening tool but provide clinical insight | 13 (34) |
| No screening tool but ask patient or review history | 5 (13) |
| Pennsylvania Prescription Drug Monitoring Program | 3 (8) |
| Did not answer question appropriately | 1 (3) |
| Question 5: What screening tools do you administer to examine for substance use disorder? | |
| No standardized tool | 35 (92) |
| No screening tool but talk with patient or review patient history | 24 (63) |
| No routine use of a screening tool | 11 (29) |
| Screen for other drugs | 5 (13) |
| NIDA Drug Use Screening Tool: Quick Screen | 1 (3) |
| Pennsylvania Prescription Drug Monitoring Program | 1 (3) |
| 5Ps (Parents, Peers, Partner, Past, Present) | 1 (3) |
| Question 6: The Commonwealth of Pennsylvania guidelines also suggest nonpharmacologic therapies should be used whenever possible to manage pain during pregnancy. What are your thoughts/beliefs on using these therapies after delivery? | |
| Like to use | 24 (63) |
| Use on a case-by-case basis | 9 (24) |
| Not sure if therapies work | 2 (5) |
| Not familiar with these guidelines | 1 (3) |
| Did not answer question appropriately | 2 (5) |
ACOG, American College of Obstetricians and Gynecologists;CDC, Centers for Disease Control and Prevention.
Data are n (%).
*
Participants may have provided responses to more than one theme so some frequency totals may exceed the number of physicians that were interviewed.
†
Thirty-eight physicians completed questions 1–6.