Schiel Kimberly Zoberi, Everard Kelly M
Department of Family Medicine, Saint Louis University School of Medicine.
Department of Family Medicine, Saint Louis University School of Medicine, St Louis, MO.
Fam Med. 2020 May;52(5):361-363. doi: 10.22454/FamMed.2020.335033.
The management of chronic pain is an important topic for training competent family physicians. The purpose of this study was to determine factors in teaching about chronic pain and whether state overdose death rates were associated with teaching chronic pain topics.
Data were collected as part of the 2019 Council of Academic Family Medicine Educational Research Alliance (CERA) Clerkship Directors' Survey. The response rate was 71%. Respondents answered questions about the amount of time spent teaching about chronic pain diagnoses, approach to chronic pain, opioid medications, nonopioid medications and nonpharmacologic treatments for chronic pain.
The most frequent topic was chronic pain diagnoses, taught by 64% of clerkships with an average of 92 minutes spent on the topic. Each chronic pain topic was taught by nearly 50% of clerkships, and 72.3% of clerkships taught at least one topic. More clerkships were teaching about opioids, nonopioids, and nonpharmacological treatments for chronic pain than in 2014. Time currently spent teaching about opioids was positively correlated with clerkships' state 2014 drug overdose death rate.
The majority of family medicine clerkships teach about chronic pain, and the amount of time dedicated to this topic has increased over the last 5 years. A state's opioid overdose rate correlates with the amount of time spent teaching about opioids, but does not correlate with the amount of time teaching about other chronic pain subtopics. It is possible that the opioid crisis is causing a shift in the subtopics of chronic pain teaching.
慢性疼痛的管理是培养合格家庭医生的重要课题。本研究的目的是确定慢性疼痛教学中的影响因素,以及各州药物过量死亡率是否与慢性疼痛主题的教学相关。
数据收集于2019年学术家庭医学教育研究联盟(CERA)临床实习主任调查。回复率为71%。受访者回答了关于慢性疼痛诊断教学时间、慢性疼痛治疗方法、阿片类药物、非阿片类药物以及慢性疼痛非药物治疗方面的问题。
最常讲授的主题是慢性疼痛诊断,64%的临床实习课程讲授该主题,平均花费92分钟。每个慢性疼痛主题由近50%的临床实习课程讲授,72.3%的临床实习课程讲授至少一个主题。与2014年相比,更多的临床实习课程讲授慢性疼痛的阿片类药物、非阿片类药物和非药物治疗。目前用于讲授阿片类药物的时间与临床实习所在州2014年的药物过量死亡率呈正相关。
大多数家庭医学临床实习课程讲授慢性疼痛,并且在过去5年中用于该主题的时间有所增加。一个州的阿片类药物过量率与讲授阿片类药物的时间相关,但与讲授其他慢性疼痛子主题的时间无关。阿片类药物危机可能正在导致慢性疼痛教学子主题的转变。