School of Medicine-Wichita, Department of Family and Community Medicine, University of Kansas, Wichita, KS.
evolvedMD, Scottsdale, AZ.
Fam Med. 2023 Feb;55(2):111-114. doi: 10.22454/FamMed.2022.729045. Epub 2023 Jan 7.
It is documented that some of the opioids prescribed to manage chronic pain are diverted and used for nonmedical purposes. We investigated whether a skill-based, chronic pain management (CPM) educational program could improve first-year family medicine residents' comfort, knowledge, and concerns in assessing and managing patients who use opioids for chronic noncancer pain.
A total of 72 first-year residents (four cohorts of 18) participated in a 3-month CPM training intervention that consisted of didactic lectures, objective structured clinical examination (OSCE) activities, and post-OSCE debriefing with faculty, one being a behavioral health specialist, between 2017 and 2020. We used a single-sample, pre/post design. At three points in time (baseline, 3-months, and 6-months postintervention), participants completed a set of measures assessing comfort, knowledge, and concern. We used repeated measures analyses to assess changes in outcome measures.
Participants reported improvements compared with baseline at both follow-up time points. At 6 months postintervention, the participants had significantly better scores on measures of comfort (F[1, 71]=65.22; P<.001), knowledge (F[1, 71]=22.38, P<.001), and concern (F[1, 71]=37.89, P<.001) in prescribing opioids for chronic noncancer pain.
A multiactivity CPM educational program for first-year residents was associated with improvement in perceived sense of comfort, knowledge, and concerns in assessing and managing patients who use opioids for chronic noncancer pain. CPM training interventions may be an effective tool to educate first-year residents to implement best practices for pain management with the goal of reducing the chances of inappropriately prescribing controlled substances or denying analgesia.
有文献记载,用于治疗慢性疼痛的一些阿片类药物被转移并用于非医疗目的。我们研究了一项基于技能的慢性疼痛管理(CPM)教育计划是否可以提高第一年家庭医学住院医师评估和管理慢性非癌痛患者时的舒适度、知识和担忧。
共有 72 名第一年住院医师(四组,每组 18 名)参加了一项为期 3 个月的 CPM 培训干预,该干预包括讲座、客观结构化临床考试(OSCE)活动以及与教职员工(包括一名行为健康专家)的 OSCE 后讨论,时间为 2017 年至 2020 年。我们使用了单样本、前后设计。在三个时间点(基线、3 个月和干预后 6 个月),参与者完成了一套评估舒适度、知识和担忧的量表。我们使用重复测量分析来评估结果测量的变化。
与基线相比,参与者在两个随访时间点都报告了改善。在干预后 6 个月,参与者在评估和管理慢性非癌痛患者使用阿片类药物的舒适度(F[1,71]=65.22;P<.001)、知识(F[1,71]=22.38,P<.001)和关注(F[1,71]=37.89,P<.001)方面的得分显著提高。
针对第一年住院医师的多活动 CPM 教育计划与提高评估和管理慢性非癌痛患者使用阿片类药物的舒适度、知识和关注感相关。CPM 培训干预可能是教育第一年住院医师实施最佳疼痛管理实践的有效工具,目标是减少不恰当地开处管制药物或拒绝镇痛的可能性。