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Opioid prescribing attitudes of palliative care physicians versus other specialists: a questionnaire-based survey
  1. Tomasz Dzierzanowski1,
  2. Michael Kozlowski2
  1. 1Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, Warszawa, Poland
  2. 2Clinic of Pain Treatment and Palliative Care, Chair of Internal Medicine and Geriatrics, Jagiellonian University Medical College, Krakow, Poland
  1. Correspondence to Dr Tomasz Dzierzanowski, Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, Warszawa 02-007, Poland; tomasz.dzierzanowski{at}


Purpose of the study While opioid overuse is a public health crisis in the USA, opioid analgesics are used suboptimally in Central and Eastern Europe, causing many pain cases to remain untreated or undertreated.

Study design This questionnaire study aimed to identify the prevalent prescribing patterns and attitudes and the possible internal impediments to optimal opioid use among palliative care physicians and other specialists in Poland.

Results Tramadol was the most commonly preferred opioid. While palliative care physicians (n=81) used various strong opioids, other physicians (n=87) prescribed mostly buprenorphine, accessible with standard prescription forms. Neither internal prejudices and beliefs nor administrative regulations impede prescribing opioids by palliative care physicians, unlike specialists other than palliative medicine. Special prescription forms for psychoactive medications, fear of drug addiction of their patients and penalties for possible errors on prescriptions affect the latter’s optimal prescribing. They also revealed significant gaps in the knowledge of prescribing opioids and would take part in additional training. Palliative care physicians appeared optimally prepared for cancer pain management and report fewer internal barriers than other specialists.

Conclusions Continuous medical education on cancer pain treatment should be provided to all specialists to ensure optimal opioid pharmacotherapy and avoid overprescribing or underprescribing opioids. Administrative restrictions are the main barrier to optimal pain treatment.

  • adult palliative care
  • health policy
  • cancer pain
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  • Contributors TD: the conception and design of the work, the acquisition, analysis and interpretation of data, drafting the work and revisions, final approval of the version published. MK: the interpretation of data, the discussion and conclusions, revisions of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Combined data in .csf or .xlsx files can be obtained on direct request to the corresponding author for verification process or any academic purposes.

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