title: Knowledge, Attitude and Practice Survey of Prescribing Opioids for Chronic Noncancer Pain in Taiwan-Comparison of Pain and Non-Pain Physicians.
abstract: Prescribing opioids for chronic noncancer pain (CNCP) has been strictly regulated in Taiwan. This study was undertaken to survey pain and non-pain related physicians' knowledge, attitudes, and practices regarding prescribing opioids for CNCP.
  
  
  
  A questionnaire survey was conducted in this comparison study. All 66 physicians who were treating officially registered CNCP outpatients were visited and completed anonymous questionnaires. The other physicians (anesthesiologists, oncologists, and non-pain physicians) were surveyed by a mailed questionnaire.
  
  
  
  A total of 266 (75%) questionnaires were received from 355 board-certified physicians. More CNCP physicians (81.8%) and anesthesiologists (69.7%) had received prior CNCP-related training courses than had oncologists (21.2%) and non-pain physicians (10.3%). Varied proportions of physicians by type were unfamiliar with the Taiwan opioid regulations (16.7-86.8%) and would accordingly skip or reduce dosage of opioid prescriptions (27.3-73.5%). In addition, non-pain physicians had a significantly lower knowledge level, more negative attitudes, and greater hesitation about prescribing opioids compared to the pain-related physicians (P < 0.001). CNCP physicians who had received CNCP-related training courses had a higher knowledge score than did those not receiving training (P = 0.002). Overall, the leading barriers for prescribing opioids were inadequate knowledge of pain management (76%), physician reluctance (73%), and family reluctance (78%).
  
  
  
  There are substantial knowledge gaps, negative attitudes, and hesitation toward prescribing long-term opioids for CNCP patients by physicians in Taiwan, suggesting that efforts are needed to improve postgraduate education regarding adequate opioid management for CNCP.
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital.
authors.forename: Tso-Chou
authors.initials: TC
authors.lastname: Lin
authors.affiliation: Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Luo-Ping
authors.initials: LP
authors.lastname: Ger
authors.affiliation: Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.|Department of Pharmacology, School of Medicine.
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Pergolizzi
authors.affiliation: Department of Pharmaceutical Sciences, School of Pharmacy, Temple University, Philadelphia, Pennsylvania, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Raffa
authors.affiliation: Academy of Humanities and Innovation, Taipei City Hospital, School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ju-O
authors.initials: JO
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital.
authors.forename: Shung-Tai
authors.initials: ST
authors.lastname: Ho
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000072080:Anesthesiologists; D001291:Attitude of Health Personnel; D059350:Chronic Pain / Q000188:drug therapy*; D002983:Clinical Competence; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D008297:Male; D000072103:Oncologists; D000072163:Ophthalmologists; D000072220:Otolaryngologists; D059408:Pain Management; D000072143:Pediatricians; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013624:Taiwan
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic Pain; Noncancer; Opioid; Physician