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Pharmacist-Physician Communication Enables Better Opioid Prescribing Decisions

RESEARCH TRIANGLE PARK—A recent report suggests that communication between opioid prescribers and pharmacists may not always flow as smoothly as anticipated.

Researchers conducted in-depth individual interviews with 60 pharmacists and 48 primary care physicians across four U.S. states. Analysis of the responses showed that both physicians and pharmacists agreed that some types of communication were generally more positive than others.

Both parties also agreed that physical proximity between physicians and pharmacists—that is, when both work for the same healthcare system or in the same building—also increased the likelihood for more frequent and positive communication.

“When pharmacists and physicians both worked in a large university-affiliated research hospital, for example, they were more likely to have interacted face-to-face and to think of each other as teammates,” said Mark Edlund, MD/PhD, one of the investigators on the study and a senior research scientist at RTI International.

However, the opinions of pharmacists and physicians diverged in other areas. Although physicians agreed that it was generally easy to get in touch with pharmacists, pharmacists noted that it was often difficult to reach physicians. Many pharmacists described calling to request missing information for a prescription and being required to leave a message, causing delays in getting the medication to the patient.

In general, pharmacists also reported feeling uncomfortable with seeming to question a physician’s judgment. This reluctance appears to be based on unspoken hierarchies within the medical profession as well as previous negative or defensive reactions to questioning from physicians.

“Calls related to questions about the dosage or timing of the prescription, or reporting evidence that a patient might be misusing opioid medications, were viewed more positively by both prescribers and pharmacists,” said Dr. Edlund. “In fact, physicians noted instances where a pharmacist alerted them to a patient who had several opioid prescriptions with different doctors, sparing them from potential legal consequences.”

Although both prescribers and physicians expressed a desire for improved communication, further research is necessary to explore strategies for encouraging positive communication. Increased communication between these two groups could improve decision-making around prescribing and dispensing prescription opioids and also prevent opioid misuse and diversion.

The report, published in Research in Social and Administrative Pharmacy, was based on findings from a National Institute on Drug Abuse–funded study. Another report from the same study was published about how physicians and pharmacists use prescription drug monitoring programs. View a description of the key findings here.