Dagher Tanios, Tilmon Sandra, Landi Andrea, Beckman Nancy, Elwyn Glyn, Lazar Danielle, Kagarmanova Ainur, Johnson Daniel, Rodriguez Isa, Laiteerapong Neda, Ari Mim, Thompson Katherine
Pritzker School of Medicine, University of Chicago.
Department of Pediatrics, University of Chicago Medicine.
Gerontol Geriatr Educ. 2024 Sep 19:1-11. doi: 10.1080/02701960.2024.2399071.
Chronic pain, opioid use, and opioid use disorder (OUD) are increasingly common in older adults. Outpatient clinician education may improve outcomes. Our aim was to create and evaluate a novel curriculum for outpatient clinicians on older adult pain management, opioid prescribing, and OUD leveraging Project ECHO®, a model for delivering subspecialized medical knowledge to community outpatient clinicians via videoconferencing.The series is comprised of 8-hour-long sessions, each with an expert-led interactive lectures followed by participant-led case discussions. Topics include pain assessment & treatment, considerations in older adults (e.g. cognition, caregiver support), shared decision-making, behavioral health, and OUD diagnosis and treatment.Sixty-nine clinicians attended the series and completed the pre-series survey; 78% ( = 54) completed the post-series survey. Clinicians reported a significant increase in self-efficacy in 14/14 queried competencies and greater frequency of performing 7/10 practice behaviors regarding older adult pain management, opioid prescribing, and OUD management. The most liked curricular components were opportunities to learn with subspecialists and discussions with other community clinicians. Qualitative analysis suggests that clinicians may benefit from education on specific geriatrics-related content areas.This novel curriculum has potential to improve management of older adult chronic pain, opioid prescribing, and OUD in a virtual and scalable format.
慢性疼痛、阿片类药物使用及阿片类药物使用障碍（OUD）在老年人中越来越常见。门诊临床医生教育可能会改善治疗效果。我们的目标是创建并评估一门针对门诊临床医生的新型课程，内容涉及老年疼痛管理、阿片类药物处方开具及OUD，该课程利用了ECHO项目，这是一种通过视频会议向社区门诊临床医生传授专科医学知识的模式。该系列课程由时长8小时的课程组成，每节课都有专家主导的互动讲座，随后是学员主导的病例讨论。主题包括疼痛评估与治疗、老年人相关考量因素（如认知、照护者支持）、共同决策、行为健康以及OUD的诊断与治疗。69名临床医生参加了该系列课程并完成了课前调查；78%（n = 54）完成了课后调查。临床医生报告称，在14项被询问的能力中，自我效能感显著提高，并且在老年疼痛管理、阿片类药物处方开具及OUD管理方面，7/10种实践行为的执行频率更高。最受欢迎的课程组成部分是与专科医生一起学习的机会以及与其他社区临床医生的讨论。定性分析表明，临床医生可能会从特定老年医学相关内容领域的教育中受益。这一新型课程有潜力以虚拟且可扩展的形式改善老年人慢性疼痛、阿片类药物处方开具及OUD的管理。
