{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:32:10Z","timestamp":1790883130545,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR001856"],"award-info":[{"award-number":["KL2TR001856"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K08CA263317"],"award-info":[{"award-number":["K08CA263317"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["3UG1DA049436\u201002S"],"award-info":[{"award-number":["3UG1DA049436\u201002S"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opioid pain management in cancer survivorship is a complex and understudied topic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The authors conducted in\u2010depth, qualitative interviews to understand clinician approaches to opioid pain management in chronic cancer pain and to generate ideas for improvement. They used a rigorous, inductive, qualitative, descriptive approach to examine clinician (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a020) perspectives about opioid pain management in survivorship, including oncologists (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a05), palliative care clinicians (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a08), primary care clinicians (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a05), and pain management specialists (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The findings indicated that no consistent medical home exists for chronic pain management in cancer survivors and that there are fundamental differences in how each subspecialty approaches chronic pain management in survivorship (e.g., \u201cDo we think of this as noncancer pain or cancer pain?\u2026 This is in this limbo zone\u2014this gray zone\u2014because it's cancer\u2010related pain, right?\u201d). Simultaneously, clinicians are influenced by their peers' perceptions of their opioid prescribing decisions, sparking intraprofessional tension when disagreement occurs. In these instances, clinicians described\n                      <jats:italic>overthinking<\/jats:italic>\n                      and doubting their clinical decision\u2010making as well as a sense of judgment, pressure, and\/or shame. Finally, clinicians acknowledged a fear of consequences for opioid prescribing decisions. Specifically, participants cited conflict with patients, sometimes escalating to aggression and threats of violence, as well as potential disciplinary actions and\/or legal consequences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participants suggested that opportunities to improve chronic cancer pain care include developing clear, systematic guidance for chronic cancer pain management, facilitating clinician communication and consultation, creating tailored survivorship care plans in partnership with patients, and developing accessible, evidence\u2010based, complementary pain treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.35299","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T06:09:31Z","timestamp":1712124571000},"page":"3034-3042","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["\u201cTo prescribe or not to prescribe, that is the question\u201d: Perspectives on opioid prescribing for chronic, cancer\u2010related pain from clinicians who treat pain in survivorship"],"prefix":"10.1002","volume":"130","author":[{"given":"Hailey W.","family":"Bulls","sequence":"first","affiliation":[{"name":"Section of Palliative Care and Medical Ethics Division of General Internal Medicine Department of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Palliative Research Center University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Challenges in Managing and Preventing Pain Clinical Research Center University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Hamm","sequence":"additional","affiliation":[{"name":"Qualitative, Evaluation, and Stakeholder Engagement Services Center for Research on Health Care Data Center University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Wasilewski","sequence":"additional","affiliation":[{"name":"Qualitative, Evaluation, and Stakeholder Engagement Services Center for Research on Health Care Data Center University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Olejniczak","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine Center for Research on Health Care University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah G.","family":"Bell","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology Department of Obstetrics and Gynecology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane M.","family":"Liebschutz","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine Center for Research on Health Care University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198507253130421"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/07347332.2020.1848967"},{"key":"e_1_2_9_4_1","volume-title":"From Cancer Patient to Cancer Survivor: Lost in Transition","author":"National Research Council, Institute of Medicine, National Cancer Policy Board, et\u00a0al., eds","year":"2006"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201012\u20100740"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/IJERPH19053037"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/10499091231164634"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.12.340"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1526\u20104637.2010.00880.X"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAONCOL.2019.1439"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.5206"},{"key":"e_1_2_9_12_1","volume-title":"NCCN Guidelines\u00ae Version 1.2024. 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