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Decision support for chronic pain care: how do primary care physicians decide when to prescribe opioids? a qualitative study

Overview of attention for article published in BMC Family Practice, April 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (77th percentile)

Mentioned by

twitter
11 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
35 Dimensions

Readers on

mendeley
124 Mendeley
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Title
Decision support for chronic pain care: how do primary care physicians decide when to prescribe opioids? a qualitative study
Published in
BMC Family Practice, April 2015
DOI 10.1186/s12875-015-0264-3
Pubmed ID
Authors

Christopher A Harle, Sarah E Bauer, Huong Q Hoang, Robert L Cook, Robert W Hurley, Roger B Fillingim

Abstract

Primary care physicians struggle to treat chronic noncancer pain while limiting opioid misuse, abuse, and diversion. The objective of this study was to understand how primary care physicians perceive their decisions to prescribe opioids in the context of chronic noncancer pain management. This question is important because interventions, such as decision support tools, must be designed based on a detailed understanding of how clinicians use information to make care decisions. We conducted in-depth qualitative interviews with family medicine and general internal medicine physicians until reaching saturation in emergent themes. We used a funneling approach to ask a series of questions about physicians' general decision making challenges and use of information when considering chronic opioids. We then used an iterative, open-coding approach to identify and characterize themes in the data. We interviewed fifteen physicians with diverse clinical experiences, demographics, and practice affiliations. Physicians said that general decision making challenges in providing pain management included weighing risks and benefits of opioid therapies and time and resource constraints. Also, some physicians described their active avoidance of chronic pain treatment due to concerns about opioid risks. In their decision making, physicians described the importance of objective and consistent information, the importance of identifying "red flags" related to risks of opioids, the importance of information about physical function as an outcome, and the importance of information that engenders trust in patients. This study identified and described primary care physicians' struggles to deliver high quality care as they seek and make decisions based on an array of incomplete, conflicting, and often untrusted patient information. Decision support systems, education, and other interventions that address these challenges may alleviate primary care physicians' struggles and improve outcomes for patients with chronic pain and other challenging conditions.

Twitter Demographics

The data shown below were collected from the profiles of 11 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 124 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 <1%
Unknown 123 99%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 26 21%
Student > Master 22 18%
Student > Bachelor 15 12%
Researcher 14 11%
Other 8 6%
Other 21 17%
Unknown 18 15%
Readers by discipline Count As %
Medicine and Dentistry 34 27%
Nursing and Health Professions 16 13%
Social Sciences 13 10%
Psychology 10 8%
Agricultural and Biological Sciences 7 6%
Other 20 16%
Unknown 24 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 February 2016.
All research outputs
#3,835,536
of 16,486,412 outputs
Outputs from BMC Family Practice
#467
of 1,674 outputs
Outputs of similar age
#42,345
of 186,025 outputs
Outputs of similar age from BMC Family Practice
#1
of 1 outputs
Altmetric has tracked 16,486,412 research outputs across all sources so far. Compared to these this one has done well and is in the 76th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,674 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 186,025 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 77% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them