Analgesic prescribing habits and patterns of Canadian chief urology residents: A national survey

  • Ali Dergham Queen's University
  • Greg Hosier Queen's University, Department of Urology
  • Melanie Jaeger Queen's University, Deparment of Anesthesiology and Perioperative Medicine
  • J. Curtis Nickel Queen's University, Department of Urology
  • D. Robert Siemens Queen's University, Department of Urology
  • Thomas McGregor Queen's University
Keywords: Opioid Prescribing habits, Resident education, Pain Management

Abstract

Introduction: Prior studies have identified significant knowledge gaps in acute and chronic pain management among graduating urology residents as of five years ago. Since then, there has been increasing awareness of the impact of excessive opioid prescribing on long-term narcotic use and development of adverse narcotic-related events. However, it is unclear whether the attitudes and experience of graduating urology residents have changed. We set out to evaluate the attitudes and experience of graduating urology residents in prescribing opioid/non-opioid analgesia for acute (AP), chronic non-cancer (CnC), and chronic cancer (CC) pain.

Methods: Graduating urology residents were surveyed at a review course in 2018. The survey consisted of open-ended and close-ended five-point Likert scale questions. Descriptive statistics, Mann- Whitney U-test, and Student’s t-test were performed.

Results: A total of 32 postgraduate year-5 (PGY5) urology residents completed our survey (92% response rate). The vast majority agreed that formal training in managing AP/CnC/CC is valuable (91/78/81%). Most find their training in CnC/CC management to be inadequate and are unaware of any opioid prescribing guidelines; 66% never counsel patients on how to dispose of excess opioids. In general, 88% are comfortable prescribing opioids, whereas most are very uncomfortable prescribing cannabis or antidepressants (100% and 78%, respectively). Residents reported the acute pain service as the highest-rated resource for information, and dedicated textbooks the least.

Conclusions: This survey demonstrated that experience in pain management remains variable among urology residents. Knowledge gaps remain, particularly in the management of CC/CnC pain.

Author Biographies

Ali Dergham, Queen's University

Medical Student, Queen's University

Greg Hosier, Queen's University, Department of Urology

PGY4, Department of Urology, Queen's University

Melanie Jaeger, Queen's University, Deparment of Anesthesiology and Perioperative Medicine

Associate Professor, Queen's University, Deparment of Anesthesiology and Perioperative Medicine

J. Curtis Nickel, Queen's University, Department of Urology
  • Clinician Scientist, KGHRI
  • Professor and CIHR Tier 1 Canada Research Chair in Urologic Pain and Inflammation, Department of Urology, Queen’s University
D. Robert Siemens, Queen's University, Department of Urology
  • Clinician Scientist, KGHRI
  • Head, Department of Urology, Queen’s University, Kingston General Hospital and Hotel Dieu Hospital
Thomas McGregor, Queen's University

Queen's University

Department of Urology

Assistant Professor

Published
2020-01-20
How to Cite
Dergham, A., Hosier, G., Jaeger, M., Nickel, J. C., Siemens, D. R., & McGregor, T. (2020). Analgesic prescribing habits and patterns of Canadian chief urology residents: A national survey. Canadian Urological Association Journal, 14(6), 199-203. https://doi.org/10.5489/cuaj.6221
Section
Original Research