Physicians’ intention to prescribe hydrocodone combination products after rescheduling: A theory of reasoned action approach

Marc Labaron Fleming, Larry Driver, Sujit S. Sansgiry, Susan M. Abughosh, Matthew Wanat, Ruta V. Sawant, Erin Ferries, Kathleen Reeve, Knox H. Todd

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The U.S. Drug Enforcement Administration (DEA) rescheduled hydrocodone combination products (HCPs) in an attempt to mitigate the prescription opioid epidemic. Many in the medical and pharmacy community expressed concerns of unintended consequences as a result of rescheduling. Objectives This study examined physicians’ intentions to prescribe HCPs after rescheduling using the framework of the theory of reasoned action (TRA). Methods A cover letter containing a link to the online questionnaire was sent to physicians of the Texas Medical Association who were likely to prescribe opioids. The questionnaire assessed physicians’ intentions to prescribe HCPs after rescheduling. Predictor variables included attitude toward rescheduling, subjective norm toward HCP prescribing, and past prescribing behavior of schedule II prescriptions. All variables were measured on a 7-point, Likert-type scale. Intention to prescribe as a dependent variable was regressed over TRA variables and respondent characteristics. Results A total of 1176 usable responses were obtained, yielding a response rate of 13.3%. Mean (M) age was 53.07 ± 11 and most respondents were male (70%) and Caucasian (75%). Physicians held a moderately positive intention to prescribe HCPs (M = 4.36 ± 2.08), held a moderately negative attitude towards rescheduling, M = 4.68 ± 1.51 (reverse coded). Subjective norm was moderately low, M = 3.06 ± 1.78, and past prescribing behavior M = 2.43 ± 1.21. The linear regression analysis indicated that attitude (β = 0.10; P = 0.006), subjective norm (β = 0.35; P < 0.0001) and past prescribing behavior (β = 0.59; P < 0.0001) were significant predictors of intention to prescribe HCPs after rescheduling. Conclusions TRA was shown to be a predictive model of physicians’ intentions to prescribe HCPs after rescheduling. Overall, physicians held a moderately positive intention to prescribe HCPs. Past behavior concerning schedule II prescribing was found to be the most significant predictor of intention. Understanding the impact of federal rule changes on pain management care and patient satisfaction is necessary to determine whether this change has produced the intended consequences without harming patients in need of HCPs.

Original languageEnglish
Pages (from-to)503-512
Number of pages10
JournalResearch in Social and Administrative Pharmacy
Volume13
Issue number3
DOIs
StatePublished - 1 May 2017

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Hydrocodone
Physicians
Opioid Analgesics
Prescriptions
Appointments and Schedules
Pain Management
Patient Satisfaction
Linear regression
Regression analysis
Linear Models
Regression Analysis

Keywords

  • Hydrocodone
  • Opioid prescribing
  • Pain management
  • Prescription drug abuse
  • Rescheduling
  • Theory of reasoned action

Cite this

Fleming, Marc Labaron ; Driver, Larry ; Sansgiry, Sujit S. ; Abughosh, Susan M. ; Wanat, Matthew ; Sawant, Ruta V. ; Ferries, Erin ; Reeve, Kathleen ; Todd, Knox H. / Physicians’ intention to prescribe hydrocodone combination products after rescheduling : A theory of reasoned action approach. In: Research in Social and Administrative Pharmacy. 2017 ; Vol. 13, No. 3. pp. 503-512.
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abstract = "Background The U.S. Drug Enforcement Administration (DEA) rescheduled hydrocodone combination products (HCPs) in an attempt to mitigate the prescription opioid epidemic. Many in the medical and pharmacy community expressed concerns of unintended consequences as a result of rescheduling. Objectives This study examined physicians’ intentions to prescribe HCPs after rescheduling using the framework of the theory of reasoned action (TRA). Methods A cover letter containing a link to the online questionnaire was sent to physicians of the Texas Medical Association who were likely to prescribe opioids. The questionnaire assessed physicians’ intentions to prescribe HCPs after rescheduling. Predictor variables included attitude toward rescheduling, subjective norm toward HCP prescribing, and past prescribing behavior of schedule II prescriptions. All variables were measured on a 7-point, Likert-type scale. Intention to prescribe as a dependent variable was regressed over TRA variables and respondent characteristics. Results A total of 1176 usable responses were obtained, yielding a response rate of 13.3{\%}. Mean (M) age was 53.07 ± 11 and most respondents were male (70{\%}) and Caucasian (75{\%}). Physicians held a moderately positive intention to prescribe HCPs (M = 4.36 ± 2.08), held a moderately negative attitude towards rescheduling, M = 4.68 ± 1.51 (reverse coded). Subjective norm was moderately low, M = 3.06 ± 1.78, and past prescribing behavior M = 2.43 ± 1.21. The linear regression analysis indicated that attitude (β = 0.10; P = 0.006), subjective norm (β = 0.35; P < 0.0001) and past prescribing behavior (β = 0.59; P < 0.0001) were significant predictors of intention to prescribe HCPs after rescheduling. Conclusions TRA was shown to be a predictive model of physicians’ intentions to prescribe HCPs after rescheduling. Overall, physicians held a moderately positive intention to prescribe HCPs. Past behavior concerning schedule II prescribing was found to be the most significant predictor of intention. Understanding the impact of federal rule changes on pain management care and patient satisfaction is necessary to determine whether this change has produced the intended consequences without harming patients in need of HCPs.",
keywords = "Hydrocodone, Opioid prescribing, Pain management, Prescription drug abuse, Rescheduling, Theory of reasoned action",
author = "Fleming, {Marc Labaron} and Larry Driver and Sansgiry, {Sujit S.} and Abughosh, {Susan M.} and Matthew Wanat and Sawant, {Ruta V.} and Erin Ferries and Kathleen Reeve and Todd, {Knox H.}",
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Physicians’ intention to prescribe hydrocodone combination products after rescheduling : A theory of reasoned action approach. / Fleming, Marc Labaron; Driver, Larry; Sansgiry, Sujit S.; Abughosh, Susan M.; Wanat, Matthew; Sawant, Ruta V.; Ferries, Erin; Reeve, Kathleen; Todd, Knox H.

In: Research in Social and Administrative Pharmacy, Vol. 13, No. 3, 01.05.2017, p. 503-512.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Physicians’ intention to prescribe hydrocodone combination products after rescheduling

T2 - A theory of reasoned action approach

AU - Fleming, Marc Labaron

AU - Driver, Larry

AU - Sansgiry, Sujit S.

AU - Abughosh, Susan M.

AU - Wanat, Matthew

AU - Sawant, Ruta V.

AU - Ferries, Erin

AU - Reeve, Kathleen

AU - Todd, Knox H.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background The U.S. Drug Enforcement Administration (DEA) rescheduled hydrocodone combination products (HCPs) in an attempt to mitigate the prescription opioid epidemic. Many in the medical and pharmacy community expressed concerns of unintended consequences as a result of rescheduling. Objectives This study examined physicians’ intentions to prescribe HCPs after rescheduling using the framework of the theory of reasoned action (TRA). Methods A cover letter containing a link to the online questionnaire was sent to physicians of the Texas Medical Association who were likely to prescribe opioids. The questionnaire assessed physicians’ intentions to prescribe HCPs after rescheduling. Predictor variables included attitude toward rescheduling, subjective norm toward HCP prescribing, and past prescribing behavior of schedule II prescriptions. All variables were measured on a 7-point, Likert-type scale. Intention to prescribe as a dependent variable was regressed over TRA variables and respondent characteristics. Results A total of 1176 usable responses were obtained, yielding a response rate of 13.3%. Mean (M) age was 53.07 ± 11 and most respondents were male (70%) and Caucasian (75%). Physicians held a moderately positive intention to prescribe HCPs (M = 4.36 ± 2.08), held a moderately negative attitude towards rescheduling, M = 4.68 ± 1.51 (reverse coded). Subjective norm was moderately low, M = 3.06 ± 1.78, and past prescribing behavior M = 2.43 ± 1.21. The linear regression analysis indicated that attitude (β = 0.10; P = 0.006), subjective norm (β = 0.35; P < 0.0001) and past prescribing behavior (β = 0.59; P < 0.0001) were significant predictors of intention to prescribe HCPs after rescheduling. Conclusions TRA was shown to be a predictive model of physicians’ intentions to prescribe HCPs after rescheduling. Overall, physicians held a moderately positive intention to prescribe HCPs. Past behavior concerning schedule II prescribing was found to be the most significant predictor of intention. Understanding the impact of federal rule changes on pain management care and patient satisfaction is necessary to determine whether this change has produced the intended consequences without harming patients in need of HCPs.

AB - Background The U.S. Drug Enforcement Administration (DEA) rescheduled hydrocodone combination products (HCPs) in an attempt to mitigate the prescription opioid epidemic. Many in the medical and pharmacy community expressed concerns of unintended consequences as a result of rescheduling. Objectives This study examined physicians’ intentions to prescribe HCPs after rescheduling using the framework of the theory of reasoned action (TRA). Methods A cover letter containing a link to the online questionnaire was sent to physicians of the Texas Medical Association who were likely to prescribe opioids. The questionnaire assessed physicians’ intentions to prescribe HCPs after rescheduling. Predictor variables included attitude toward rescheduling, subjective norm toward HCP prescribing, and past prescribing behavior of schedule II prescriptions. All variables were measured on a 7-point, Likert-type scale. Intention to prescribe as a dependent variable was regressed over TRA variables and respondent characteristics. Results A total of 1176 usable responses were obtained, yielding a response rate of 13.3%. Mean (M) age was 53.07 ± 11 and most respondents were male (70%) and Caucasian (75%). Physicians held a moderately positive intention to prescribe HCPs (M = 4.36 ± 2.08), held a moderately negative attitude towards rescheduling, M = 4.68 ± 1.51 (reverse coded). Subjective norm was moderately low, M = 3.06 ± 1.78, and past prescribing behavior M = 2.43 ± 1.21. The linear regression analysis indicated that attitude (β = 0.10; P = 0.006), subjective norm (β = 0.35; P < 0.0001) and past prescribing behavior (β = 0.59; P < 0.0001) were significant predictors of intention to prescribe HCPs after rescheduling. Conclusions TRA was shown to be a predictive model of physicians’ intentions to prescribe HCPs after rescheduling. Overall, physicians held a moderately positive intention to prescribe HCPs. Past behavior concerning schedule II prescribing was found to be the most significant predictor of intention. Understanding the impact of federal rule changes on pain management care and patient satisfaction is necessary to determine whether this change has produced the intended consequences without harming patients in need of HCPs.

KW - Hydrocodone

KW - Opioid prescribing

KW - Pain management

KW - Prescription drug abuse

KW - Rescheduling

KW - Theory of reasoned action

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