Table 3.
Proportion of correct responses to seven medicolegal and eleven clinical opioid questions of the KnowPain-50 survey
| Opioid questions | Strongly agree | Agree | Somewhat agree | Somewhat disagree | Disagree | Strongly disagree | Percent correct |
|---|---|---|---|---|---|---|---|
| Medicolegal opioid questions | |||||||
| Prescribing investigated, I am confident I would pass | 46 (37%)* | 43 (34%)* | 28 (22%)* | 6 (5%) | 3 (2%) | 0 (0%) | 93% |
| Unlawful to prescribe to a patient with known substance abuse | 3 (2) | 8 (6) | 7 (5) | 14 (11)* | 66 (52)* | 30 (23)* | 86 |
| Federal law permits post-dated prescriptions | 5 (4) | 21 (16) | 4 (3) | 14 (11)* | 42 (33)* | 42 (34)* | 78 |
| I know how to find state, federal requirements | 18 (14)* | 45 (35)* | 22 (17)* | 23 (18) | 17 (13) | 2 (2) | 67 |
| Illegal to prescribe methadone unless addiction certified | 19 (15) | 19 (15) | 7 (6) | 8 (6)* | 42 (33)* | 32 (25)* | 65 |
| I understand state, federal requirements | 14 (11)* | 33 (26)* | 32 (25)* | 31 (24) | 15 (12) | 2 (2) | 62 |
| Federal regulations limit the number of prescribed dosages | 8 (6) | 29 (23) | 14 (11) | 19 (15)* | 46 (36)* | 11 (9)* | 60 |
| Clinical opioid questions | |||||||
| The elderly cannot tolerate opioids | 2 (2) | 5 (4) | 8 (6) | 18 (14)* | 71 (55)* | 24 (19)* | 88 |
| Most common opioid adverse effect. Answer: constipation | 110 (86)** | – | – | – | – | 18 (14) | 86 |
| Long-term NSAIDs have higher risks than opioids | 7 (5)* | 41 (32)* | 47 (37)* | 16 (13) | 12 (9) | 5 (4) | 74 |
| No opioids for patients with a likely drug abuser profile | 5 (4) | 7 (5) | 23 (18) | 47 (37)* | 38 (30)* | 8 (6)* | 73 |
| No opioids for chronic pain of unknown cause | 4 (3) | 9 (7) | 22 (17) | 36 (28)* | 49 (39)* | 7 (6)* | 72 |
| Chronic opioid therapy has high risk of addiction in adults >40 years of age without history of substance abuse | 1 (1) | 22 (17) | 24 (19) | 27 (21) | 40 (31) | 14 (11) | 63 |
| Morphine-induced sedation usually clears with long-term use | 6 (5)* | 25 (20)* | 39 (30)* | 27 (21) | 26 (20) | 5 (4) | 55 |
| Physiologic basis for pain should be primary factor for opioids | 2 (2) | 23 (18) | 33 (26) | 40 (31)* | 26 (20)* | 3 (2)* | 54 |
| There is a ceiling dose for opioids | 8 (6) | 26 (20) | 25 (20) | 20 (16)* | 36 (28)* | 13 (10)* | 54 |
| I am comfortable calculating | 12 (9)* | 21 (16)* | 35 (27)* | 29 (23) | 22 (17) | 9 (7) | 53 |
| conversion doses of opioids | |||||||
| Analgesic tolerance limits long-term opioid use | 4 (3) | 30 (23) | 35 (27) | 25 (20)* | 32 (25)* | 2 (2)* | 46 |
Notes:
*
Correct answer.
**
Multiple-choice single answer question where data for the correct answer given is shown in the “Strongly agree” column, and the data for the incorrect answer given is shown in the “Strongly disagree” column.
Abbreviation: NSAIDs, nonsteroidal anti-inflammatory drugs.