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A Physician Survey of Patient Counseling Practices on Safe Opioid Storage and Disposal

Elizabeth Marrett, MPH (Daiichi Sankyo, Inc., Basking Ridge, NJ, United States); Razmic Gregorian, Jr.; Vivek Sivathanu; Mariana Torgal, Msc; Sejal Shah; Winghan Jacqueline Kwong, PharmD, PhD; Jeffrey Gudin, MD

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Saturday, November 16, 2019

Session Title: Section Info: Annual Assembly Posters (Non Presentations)

Session Time: 11:15am-12:45pm

Location: Research Hub - Kiosk 8

Disclosures: Elizabeth Marrett, MPH: Daiichi Sankyo, Inc.: Employment

Objective: Assess physician counseling practices on safe opioid storage and disposal (S/D).

Design: Cross-sectional internet-based survey (9/24/18 –10/15/18).

Setting: Outpatient.

Participants: 300 physician specialists in surgery, emergency medicine, primary care, neurology, rheumatology, pain medicine and physical medicine & rehabilitation recalled the last patient for whom they issued a new prescription for an oral CII opioid.

Interventions: Not applicable.

Main Outcome Measures: Survey assessed physician’s practice experience, patient’s clinical characteristics, and physician’s knowledge of patient’s living arrangement and household history of substance use disorder (SUD). Further, physicians rated their perceived risk of opioid diversion in patient’s household (1=low; 5=high), and whether they counseled patients on opioid S/D.

Results: Mean [standard deviation (SD)] physician age was 46.1 (7.9) years, 76% were male. Mean (SD) years in clinical practice was 14.9 (6.8), and number of opioid prescriptions written in the week before survey completion was 33.0 (37.1). Of recalled patients, 68% were treated for acute pain. Most physicians (87%) were aware of patient’s living arrangement, and 93.7% had knowledge of patient SUD history (0.7% prior abuse). However, 45.2% of physicians were unaware of household SUD history. Mean (SD) physician perception of diversion risk was higher for chronic vs. acute pain patients [1.9 (1.0) vs. 1.6 (0.2), P=.02]. Only 44.7% and 30% of physicians reported counseling on storage and disposal, respectively. Factors that increased the likelihood of counseling on S/D included higher opioid prescribing physicians, increased days of opioid supply, treatment of chronic pain and perceived diversion risk (all P <.05).

Conclusions: Patient counseling on safe opioid S/D was not routine and appeared to be affected by physician opioid prescribing practice, pain type and perceived diversion risk. Future research assessing effectiveness of opioid S/D counseling on opioid diversion and abuse is warranted to inform clinical practice.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Marrett E, Gregorian R, Sivathanu V, Torgal M, Shah S, Kwong WJ, Gudin J. A Physician Survey of Patient Counseling Practices on Safe Opioid Storage and Disposal [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/a-physician-survey-of-patient-counseling-practices-on-safe-opioid-storage-and-disposal/. Accessed May 18, 2025.
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