Provider Self-Perception of Opioid Prescribing Often Inaccurate, Says Study

Results showed that 65% of those in the intervention group underestimated their opioid prescribing.

A significant number of physicians underestimate their opioid prescribing behaviors, according to a year-long study conducted at 4 emergency departments (EDs). 

Researchers from the University of Colorado and the University of Massachusetts sought to determine the accuracy of provider self-perception when it came to opioid prescribing practices. A total of 109 attending physicians, residents, and advanced practice providers at 4 EDs were randomized to either a no-intervention group (n=58) or a brief data-driven intervention group (n=51). The data-driven group was asked to self-identify and explicitly report their perceived opioid prescribing in comparison to peers. Following this, the intervention group was provided with their actual prescribing behavior data and also that of their peers.  

The results showed that 65% of those in the intervention group underestimated their opioid prescribing. The researchers monitored the physicians for 12 months, and subsequently found that those who underestimated their prescribing at baseline had larger-magnitude decreases in the proportion of patients discharged with an opioid prescription (primary outcome), when compared to the control group (Hodges‐Lehmann difference -2.1 prescriptions per hundred patients at 6 months [95% CI ‐3.9 to ‐0.5] and ‐2.2 per hundred at 12 months [95% CI ‐4.8 to ‐0.01]).

“After seeing their real data, the people with inaccurate self-perceptions, on average, had 2.1 fewer opioid prescriptions per 100 patients six months later and 2.2 percent fewer prescriptions per 100 patients at 12 months,” said Sean Michael, MD, MBA, and co-author of the study.

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Over the 12 months, the physicians in the study discharged 119,428 patients and wrote 75,203 prescriptions, of which 15,124 (~20%) were for opioids. 

The authors concluded that their findings, “suggest that guideline and policy interventions should directly address the potential barrier of inaccurate provider self‐awareness.”

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