OBJECTIVES:

Health care professionals (HCP) are the group primarily responsible for appropriate opioid prescribing, dispensing and promoting safe opioid use. HCP can promote safe opioid use when prescribing or dispensing opioid medications by counseling patients on the safe use of opioids including risks, storage and disposal. Literature lacks empirical evidence about communicating risks of opioids with patients when prescribing or dispensing or following up on opioid therapy nor does it sufficiently address barriers and facilitators to discuss opioid-related information from patient and HCP perspectives.

This systematic review summarizes (1) content covered in opioid consults, (2) perceptions of opioid communication among patients and health care providers (HCP), and (3) barriers and facilitators to opioid risk communication when prescribing, dispensing or following-up on opioid therapy for patients.

METHODS:

PubMed, Cinahl Plus, and Cochrane review databases were searched for original research and systematic reviews about HCP and patient communication. PRISMA guidelines were used to inform study process. The preliminary search generated 1147 studies; 28 were included for final data extraction.

RESULTS:

Sixty-eight percent of the studies were exploratory and qualitative in nature. There was a lack of open communication reported between patients and HCP about pain, treatment options, and risks of opioid medications. Communication barriers included uncertainty about HCP roles in opioid safety, lack of confidence and training on opioid communication, and lack of time.

CONCLUSIONS:

Findings from this review emphasize the differences between HCPs and patient perceptions and communication regarding risks associated with opioids. These studies suggest exploring interventions to standardize recommended content of HCP counseling across sites and settings, clarify communication roles and responsibilities of different HCP; encourage use of guidelines to facilitate consultation; and provide additional training to increase HCP confidence in opioid communication. Additional intervention research is needed to inform implementation of interventions to improve opioid communication.