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

Marc L. Fleming, Larry C 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 (US)
    Pages (from-to)503-512
    Number of pages10
    JournalResearch in Social and Administrative Pharmacy
    Volume13
    Issue number3
    DOIs
    StatePublished - May 1 2017

    Fingerprint

    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

    ASJC Scopus subject areas

    • Pharmacy
    • Pharmaceutical Science

    Cite this

    Physicians’ intention to prescribe hydrocodone combination products after rescheduling : A theory of reasoned action approach. / Fleming, Marc L.; Driver, Larry C; 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

    Fleming, Marc L. ; Driver, Larry C ; 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.",
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    T2 - A theory of reasoned action approach

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    AU - Driver, Larry C

    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.

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    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.

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    KW - Opioid prescribing

    KW - Pain management

    KW - Prescription drug abuse

    KW - Rescheduling

    KW - Theory of reasoned action

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