Finnell John T, Twillman Robert K, Breslan Stephanie A, Schultz Jan, Miller Lyerka
Regenstrief Institute, Inc, Indianapolis, Indiana; Indiana University School of Medicine, Indianapolis, Indiana.
Academy of Integrative Pain Management, Sonora, California.
Clin Ther. 2017 Sep;39(9):1896-1902.e2. doi: 10.1016/j.clinthera.2017.07.040. Epub 2017 Sep 1.
Opioid diversion, misuse, and abuse are rapidly growing problems in the United States; >60% of all drug overdose deaths involve an opioid. At least 49 states now have fully operational prescription drug monitoring programs (PDMPs) to support legitimate medical use of controlled substances; however, there is considerable underutilization of such programs.
To increase awareness of PDMPs and their use, a continuing medical education program including 2 webcasts and a series of newsletters was offered to health care providers.
Four hundred and sixty-five clinicians participated in 1 of 2 webcasts. Of those, 207 clinicians responded to a pre-survey and 64 responded to a post-survey. Slightly more than half of clinicians were registered for their state's PDMP program before the educational intervention, and although significantly more clinicians reported increased likelihood to access their state PDMP after participation, the number that actually registered only trended toward a statistically significant increase to 74% after the education (P = 0.06). Immediate post-activity evaluation also indicated that the education significantly improved clinician knowledge of the characteristics of addiction, findings in a PDMP that would suggest diversion or abuse, and strategies to complement the use of a PDMP (P < 0.001).
Continuing medical education is effective for improving clinician knowledge and confidence related to opioid misuse, abuse, and diversion and effective use of a PDMP; however, the education did not result in a significant increase in enrollment in state PDMPs.
在美国，阿片类药物转移、滥用和成瘾问题正迅速加剧；所有药物过量致死事件中，超过60%涉及阿片类药物。目前至少有49个州已全面实施处方药监测计划（PDMPs），以支持合法医疗使用管制药品；然而，此类计划的利用率仍相当低。
为提高对PDMPs及其用途的认识，向医疗服务提供者提供了一个继续医学教育项目，包括2次网络直播和一系列时事通讯。
465名临床医生参加了2次网络直播中的1次。其中，207名临床医生回复了预调查，64名回复了后调查。略超过一半的临床医生在教育干预前已注册了所在州的PDMP计划，尽管有显著更多的临床医生报告称参与后访问所在州PDMP的可能性增加，但实际注册人数仅呈上升趋势，教育后增至74%，但无统计学显著差异（P = 0.06）。活动后即时评估还表明，该教育显著提高了临床医生对成瘾特征、PDMP中表明转移或滥用的发现以及补充使用PDMP的策略的了解（P < 0.001）。
继续医学教育对于提高临床医生与阿片类药物滥用、成瘾和转移以及有效使用PDMP相关的知识和信心是有效的；然而，该教育并未导致所在州PDMP的注册人数显著增加。
