title: An evaluation of the performance of the Opioid Manager clinical tool in primary care: a qualitative study.
abstract: OBJECTIVE
  The Opioid Manager (OM) is a point-of-care paper tool for physicians, which summarizes the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. To evaluate the efficacy of the OM, there is a need to better understand how physicians are using the OM, and how it is relevant to their practice.
  
  
  METHODS
  Semistructured interviews were conducted with six family physicians in Ontario with clinical pain management experience. The interviews were analyzed using content analysis. The technique of "code-recode" was conducted by two analysts to verify content validity.
  
  
  RESULTS
  The following main themes emerged: 1) OM as a communication tool; 2) OM as an educational tool; 3) OM as a clinical tool; 4) OM content/design; 5) OM benefits; 6) who the OM is used with; 7) OM potential; and 8) challenges of pain management. Physicians' commented the OM was a useful reference for helping their clinical decision making regarding opioids, and used it to educate and communicate with their patients/colleagues. Although many felt the content/design of the OM had a number of good features, there was a need for modifications (ie, merge with other tools and create electronic version). Given the challenges associated with pain management, a number of benefits were derived from using the OM (ie, protection and building therapeutic alliance), and respondents' felt the tool had the potential to meet a number of unmet needs related to opioid management.
  
  
  CONCLUSIONS
  Overall, the OM was viewed positively for improving pain management practices but further work is required to refine the tool's potential.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Robertson
authors.affiliation: Faculty of Medicine, Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Sander L
authors.initials: SL
authors.lastname: Hitzig
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; Department of Medicine, Division of Physiatry, University of Toronto, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Furlan
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D003142:Communication; D006801:Humans; D059408:Pain Management; D019095:Point-of-Care Systems; D011320:Primary Health Care; D036301:Qualitative Research
chemical_list: D000701:Analgesics, Opioid