{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:56:42Z","timestamp":1765886202874,"version":"3.41.2"},"reference-count":40,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS023306"],"award-info":[{"award-number":["R01HS023306"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["MDM Policy &amp; Practice"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p> Background. Safe opioid prescribing and effective pain care are particularly important issues in the United States, where decades of widespread opioid prescribing have contributed to high rates of opioid use disorder. Because of the importance of clinician-patient communication in effective pain care and recent initiatives to curb rising opioid overdose deaths, this study sought to understand how clinicians and patients communicate about the risks, benefits, and goals of opioid therapy during primary care visits. Methods. We recruited clinicians and patients from six primary care clinics across three health systems in the Midwest United States. We audio-recorded 30 unique patients currently receiving opioids for chronic noncancer pain from 12 clinicians. We systematically analyzed transcribed, clinic visits to identify emergent themes. Results. Twenty of the 30 patient participants were females. Several patients had multiple pain diagnoses, with the most common diagnoses being osteoarthritis ( n = 10), spondylosis ( n = 6), and low back pain ( n = 5). We identified five themes: 1) communication about individual-level and population-level risks, 2) communication about policies or clinical guidelines related to opioids, 3) communication about the limited effectiveness of opioids for chronic pain conditions, 4) communication about nonopioid therapies for chronic pain, and 5) communication about the goal of the opioid tapering. Conclusions. Clinicians discuss opioid-related risks in varying ways during patient visits, which may differentially affect patient experiences. Our findings may inform the development and use of more standardized approaches to discussing opioids during primary care visits. <\/jats:p>","DOI":"10.1177\/2381468319892572","type":"journal-article","created":{"date-parts":[[2019,12,11]],"date-time":"2019-12-11T06:57:06Z","timestamp":1576047426000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["An Analysis of Primary Care Clinician Communication About Risk, Benefits, and Goals Related to Chronic Opioid Therapy"],"prefix":"10.1177","volume":"4","author":[{"given":"Elizabeth C.","family":"Danielson","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olena","family":"Mazurenko","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara T.","family":"Andraka-Christou","sequence":"additional","affiliation":[{"name":"College of Health & Public Affairs, University of Central Florida, Orlando, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"DiIulio","sequence":"additional","affiliation":[{"name":"Applied Decision Science, LLC, Dayton, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah M.","family":"Downs","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Hurley","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine, Winston Salem, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4803-3632","authenticated-orcid":false,"given":"Christopher A.","family":"Harle","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana"},{"name":"Regenstrief Institute Center for Biomedical Informatics, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,12,10]]},"reference":[{"key":"bibr1-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.05.002"},{"key":"bibr2-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.03.009"},{"key":"bibr3-2381468319892572","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6450a3"},{"key":"bibr4-2381468319892572","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6712a1"},{"key":"bibr5-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.02.020"},{"key":"bibr6-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"bibr7-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00689.x"},{"key":"bibr8-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnw078"},{"key":"bibr9-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1370\/afm.310"},{"issue":"2","key":"bibr10-2381468319892572","first-page":"297","volume":"19","author":"Goesling J","year":"2016","journal-title":"Pain Med"},{"key":"bibr11-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000488"},{"key":"bibr12-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1177\/160940690600500107"},{"issue":"32","key":"bibr13-2381468319892572","first-page":"1","volume":"19","author":"Cho JY","year":"2014","journal-title":"Qual Rep"},{"volume-title":"Dedoose Version 7.7.6, Web Application for Managing, Analyzing, and Presenting Qualitative and Mixed Method Research Data","year":"2017","author":"SocioCultural Research Consultants","key":"bibr14-2381468319892572"},{"key":"bibr15-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1057\/9780230239517"},{"volume-title":"Doing Qualitative Research","year":"1999","author":"Crabtree BF","key":"bibr16-2381468319892572"},{"volume-title":"Doing Qualitative Research","year":"1999","author":"Borkan J.","key":"bibr17-2381468319892572"},{"volume-title":"Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis","year":"2006","author":"Charmaz K.","key":"bibr18-2381468319892572"},{"key":"bibr19-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1177\/104973230201200211"},{"key":"bibr20-2381468319892572","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"volume-title":"Drug Overdose Deaths in the United States, 1999\u20132016","year":"2017","author":"Hedegaard H","key":"bibr21-2381468319892572"},{"key":"bibr22-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2006.00412.x"},{"key":"bibr23-2381468319892572","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2559"},{"key":"bibr24-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1053"},{"key":"bibr25-2381468319892572","doi-asserted-by":"publisher","DOI":"10.7326\/ACPJC-2017-166-2-011"},{"key":"bibr26-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnx276"},{"key":"bibr27-2381468319892572","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny307"},{"key":"bibr28-2381468319892572","unstructured":"Centers for Disease Control and Prevention. 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