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培养预防和管理处方药滥用的核心能力:马萨诸塞州的医学教育合作项目

Developing Core Competencies for the Prevention and Management of Prescription Drug Misuse: A Medical Education Collaboration in Massachusetts.

作者信息

Antman Karen H, Berman Harris A, Flotte Terence R, Flier Jeffrey, Dimitri Dennis M, Bharel Monica

机构信息

K.H. Antman is dean, Boston University School of Medicine, and provost, Boston University Medical Campus, Boston, Massachusetts.H.A. Berman is dean and professor of public health and community medicine, Tufts University School of Medicine, Boston, Massachusetts.T.R. Flotte is dean, provost and executive deputy chancellor, and Celia and Isaac Haidak Professor of Medical Education, University of Massachusetts Medical School, Worcester, Massachusetts.J. Flier is dean, Harvard Medical School, Boston, Massachusetts.D.M. Dimitri is clinical associate professor, Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, and past president, Massachusetts Medical Society, Waltham, Massachusetts.M. Bharel is commissioner, Massachusetts Department of Public Health, Boston, Massachusetts.

出版信息

Acad Med. 2016 Oct;91(10):1348-1351. doi: 10.1097/ACM.0000000000001347.

Abstract

Drug overdose has become the leading cause of injury death in the United States. More than half of those deaths involve prescription drugs, specifically opioids. A key component of addressing this national epidemic is improving prescriber practices.A review of the curricula at the four medical schools in Massachusetts revealed that, although they taught components of addiction medicine, no uniform standard existed to ensure that all students were taught prevention and management strategies for prescription drug misuse. To fill this gap, the governor and the secretary of health and human services invited the deans of the state's four medical schools to convene to develop a common educational strategy for teaching safe and effective opioid-prescribing practices. With leadership from the Department of Public Health and Massachusetts Medical Society, the deans formed the Medical Education Working Group in 2015. This group reviewed the relevant literature and current standards for treating substance use disorders and defined 10 core competencies for the prevention and management of prescription drug misuse.The medical schools have incorporated these competencies into their curricula and have committed to assessing students' competence in these areas. The members of the Medical Education Working Group have agreed to continue to work together on key next steps, including connecting these competencies to those for residents, equipping interprofessional teams to address prescription drug misuse, and developing materials in pain management and opioid misuse for practicing physicians. This first-in-the-nation partnership has yielded cross-institutional competencies that aim to address a public health emergency in real time.

摘要

药物过量已成为美国伤害死亡的首要原因。这些死亡案例中,超过半数涉及处方药,尤其是阿片类药物。应对这一全国性流行病的一个关键因素是改善开处方者的行为。对马萨诸塞州四所医学院课程的审查显示,尽管这些学校教授了成瘾医学的内容,但不存在统一标准来确保所有学生都学到了预防和管理处方药滥用的策略。为填补这一空白,州长以及卫生与公众服务部部长邀请该州四所医学院的院长召开会议,制定一项关于教授安全有效的阿片类药物处方开具方法的共同教育策略。在公共卫生部和马萨诸塞州医学协会的领导下,各位院长于2015年成立了医学教育工作组。该小组审查了治疗物质使用障碍的相关文献和现行标准,并确定了预防和管理处方药滥用的10项核心能力。各医学院已将这些能力纳入其课程,并承诺评估学生在这些领域的能力。医学教育工作组的成员已同意继续共同推进关键的后续步骤,包括将这些能力与住院医师的能力联系起来,让跨专业团队具备应对处方药滥用问题的能力,以及为执业医师编写疼痛管理和阿片类药物滥用方面的材料。这种全国首创的合作关系产生了跨机构的能力,旨在实时应对公共卫生紧急情况。

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