Trauma Trainees’ Multiple Competing Goals in Opioid Prescription Communication

Elizabeth Troutman Adams, Elisia L Cohen, Andrew Bernard, Whittney Darnell, Donald W. Helme

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Prescription opioids and heroin account for more than half of all drug overdose fatalities, costing an estimated 115 American lives every day. The ongoing opioid epidemic devastates communities and represents a tremendous burden to the national economy and health care system. In 2016, the Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy proposed action to train prescribers on the proper dispensing of opioids, which are indispensable pharmacologic resources for treating acute pain resulting from a traumatic injury or surgery. Trauma surgeons who prescribe opioids for severe pain embark on patient consultations with multiple and conflicting goals respective to their roles as a healers of the suffering, regulators of illicit substances, members of a greater medical system working to contain an opioid epidemic, and moral beings with a distinct set of preferences, experiences, social norms, and practice philosophies. Semistructured interviews with 17 trauma and surgical residents and fellows at a southeastern academic medical center in the United States generated descriptive data regarding prescribing practices and patient communication. Guided by the multiple goals framework, the current research presents three prominent themes depicting the problematic convergence of identity, task, and relational goals during opioid-prescribing conversations between trauma trainees and their patients.

Original languageEnglish (US)
Pages (from-to)1983-1996
Number of pages14
JournalQualitative Health Research
Volume28
Issue number13
DOIs
StatePublished - Nov 1 2018

Fingerprint

Multiple Trauma
Opioid Analgesics
Prescriptions
Communication
Wounds and Injuries
Drug Overdose
Drug and Narcotic Control
Heroin
Acute Pain
Centers for Disease Control and Prevention (U.S.)
Psychological Stress
Referral and Consultation
Interviews
Delivery of Health Care
Pain
Research

Keywords

  • multiple goals theory
  • opioids
  • patient–provider communication
  • prescriptions
  • qualitative interviews
  • southeastern United States

Cite this

Trauma Trainees’ Multiple Competing Goals in Opioid Prescription Communication. / Adams, Elizabeth Troutman; Cohen, Elisia L; Bernard, Andrew; Darnell, Whittney; Helme, Donald W.

In: Qualitative Health Research, Vol. 28, No. 13, 01.11.2018, p. 1983-1996.

Research output: Contribution to journalArticle

Adams, Elizabeth Troutman ; Cohen, Elisia L ; Bernard, Andrew ; Darnell, Whittney ; Helme, Donald W. / Trauma Trainees’ Multiple Competing Goals in Opioid Prescription Communication. In: Qualitative Health Research. 2018 ; Vol. 28, No. 13. pp. 1983-1996.
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