Katzman Joanna G, Warrick Brandon J, Takeda Mikiko, Bhatt Snehal, Grandhe Radhika P, Jacobsohn Vanessa, Tomedi Laura E
Department of Neurosurgery, School of Medicine, Health Sciences Center, University of New Mexico, Albuquerque, NM 87106, USA.
Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131, USA.
Healthcare (Basel). 2025 Apr 11;13(8):873. doi: 10.3390/healthcare13080873.
In 2022, more than 107,000 people died in the US from an opioid overdose. The Opioid Rapid Response and Pain (ORRP) ECHO was developed to educate primary care clinicians on best practices in pain and substance use management consistent with the 2016 Guideline for Prescribing Opioids for Chronic Pain. Six 1 h virtual sessions consisting of didactics and case discussions focusing on pain and substance use were delivered by a multidisciplinary hub team to four diverse US regions. The authors utilized qualitative analyses, including a modified Delphi Technique and thematic analysis, to assess participant questions during the sessions, focus groups with participants, and post-session survey responses for ORRP ECHO training between 14 October 2021 and 15 November 2022. One hundred and eighteen primary care clinicians performed 627 chat responses and were eligible to receive 648 continuing education unit credits. The majority of chat questions were related to Patient-Centered Care (28%, 170 total responses) and Knowledge (27%, 178 total responses). The focus groups revealed five core themes: (1) there was a clear need for the ECHO trainings, (2) the program fostered a unique and supportive community, (3) the content was applicable, (4) the administration of the program was effective, and (5) it had a meaningful impact on practice. The participants who completed the post-session surveys reported that they would apply their knowledge (range across cohorts: 85.7% to 100.0% of survey respondents agreed or strongly agreed) and communication skills gained (range: 71.4% to 98.6%). Through didactics and interactive case discussions, the ECHO model holds promise as a useful training model to support the appropriate use of clinical practice guidelines by informing individualized, patient-centered care and clinical judgment.
2022年，美国有超过10.7万人死于阿片类药物过量。阿片类药物快速反应与疼痛（ORRP）循证社区（ECHO）项目旨在根据2016年《慢性疼痛阿片类药物处方指南》，向初级保健临床医生传授疼痛和物质使用管理的最佳实践方法。一个多学科中心团队为美国四个不同地区举办了六次为时1小时的虚拟课程，内容包括讲授和以疼痛及物质使用为重点的病例讨论。作者运用定性分析方法，包括改良德尔菲技术和主题分析，来评估2021年10月14日至2022年11月15日期间课程中的参与者提问、与参与者进行的焦点小组讨论以及课后对ORRP ECHO培训的调查反馈。118名初级保健临床医生进行了627次聊天回复，并有资格获得648个继续教育学分。大多数聊天问题与以患者为中心的护理（28%，共170条回复）和知识（27%，共178条回复）相关。焦点小组揭示了五个核心主题：（1）对ECHO培训有明确需求；（2）该项目营造了一个独特且相互支持的社区；（3）内容适用；（4）项目管理有效；（5）对实践有重大影响。完成课后调查的参与者报告称，他们会应用所学知识（各队列范围：85.7%至100.0%的调查受访者表示同意或强烈同意）以及所获得的沟通技巧（范围：71.4%至98.6%）。通过讲授和互动式病例讨论，ECHO模式有望成为一种有用的培训模式，通过提供个性化、以患者为中心的护理和临床判断信息，来支持临床实践指南的合理应用。
