title: Clinical implications of patient-provider agreements in opioid prescribing.
abstract: In June, 2012 the United States Food and Drug Administration (FDA) developed a "blueprint" for prescriber education as a means of directing Certified Medical Education (CME) activities that included content which would meet the regulatory requirements of the class-wide, longacting/ extended-release (LA-ER) opioid Risk Evaluation Mitigation Strategies (REMS). Within the blueprint is the suggested adoption of Patient-Provider Agreements (PPAs) to be used in association with opioid prescribing, but, to our knowledge, there have been no reported evaluations of the role played by opioid-agent PPAs in clinical practice, or of the perceptions of this regulatory mandate by clinicians. Therefore, we conducted a survey regarding PPA perceptions by opioid prescribers that was posted for five weeks on a well-trafficked online CME service provider (Medscape). Of the 1,232 respondents (reflecting a 99.5% completion rate), 52.4% treat acute or chronic pain with opioids. The survey identified an improvement of opioid safe-use education (21% of respondents) as the most frequently selected beneficial element of PPAs. Conversely, the challenges to adoption included time constraints (21% of physicians) as well as lack of evidence that PPAs will reduce drug misuse, and the lack of a uniform, patient-friendly PPA. Based on our survey, clinicians consider the PPA of potential value, but data regarding the utility of such an instrument are lacking.
authors.affiliation: Nanotherapeutics, Inc., 13859 Progress Blvd., Suite 300 Alachua FL 32615, USA. ckraus@nanotherapeutics.com.
authors.forename: Carl N
authors.initials: CN
authors.lastname: Kraus
authors.forename: Alan T
authors.initials: AT
authors.lastname: Baldwin
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Curro
authors.forename: R G
authors.initials: RG
authors.lastname: McAllister
mesh_terms: D000701:Analgesics, Opioid; D011307:Drug Prescriptions / Q000592:standards*; D004502:Education, Medical, Continuing; D006282:Health Personnel; D006801:Humans; D007880:Legislation, Drug / Q000639:trends*; D010361:Patients; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000701:Analgesics, Opioid