(Press-News.org) (Boston)--Educating clinicians on how to safely prescribe opioids can help decrease opioid misuse among chronic pain sufferers.
These findings, which appear online in the journal Pain Medicine, confirm that education can empower clinicians to make more informed clinical decisions about initiating, continuing, changing or discontinuing opioids for patients suffering from chronic pain based on a careful benefit versus risk/harm assessment.
Chronic pain affects approximately 100 million people in the U.S. making it one of the most common reasons patients seek medical care. Undertreated chronic pain causes reduced function and quality of life, and is associated with increased rates of suicidality. However, more aggressive chronic pain management with opioid analgesics over the past two decades has been associated with an increase in prescription opioid misuse including addiction and overdose deaths.
Due to the high prevalence of prescription opioid misuse, the U.S. Food and Drug Administration (FDA) mandated a Risk Evaluation and Mitigation Strategy (REMS) requiring manufacturers of extended release/long acting (ER/LA) opioids to fund continuing education based on an FDA Blueprint.
SCOPE of Pain Program
Boston University School of Medicine (BUSM), the first Continuing Medical Education provider to receive ER/LA opioid REMS funding, launched its Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program in 2013. It is offered as a three-hour live or online activity. The live programs included 20 half-day standalone meetings across the US in 16 states. The live and online curricula are identical and presented using a clinical case involving three separate visits: initial visit - assessing chronic pain and opioid misuse risk; one week later - initiating (continuing) opioid therapy safely and months later - assessing and managing aberrant medication taking behaviors. This allows participants to apply the ER/LA opioid REMS content to a common clinical scenario.
Training Program Results
A total of 10,566 participants have completed SCOPE of Pain since its inception through June 2014. Twenty-seven percent (2,850/10,566) were considered the primary target group (defined as being physicians, advanced practice nurses or physician assistants licensed to prescribe opioid analgesics and a member of 13 specialties that routinely manage patients with chronic pain).
Immediately post-program, 87 percent of participants stated they were planning to make at least one change to align their practice with guideline-based care. The most frequently stated changes were 1) to improve opioid prescribing documentation (56 percent); 2) to implement or improve opioid prescribing patient education or communication (53 percent); and 3) to institute or improve Patient-Prescriber Agreements (47 percent).
Two months after the training, approximately two-thirds of participants reported increased confidence in guideline-based opioid prescribing practices and 86 percent improved how they prescribe opioids and monitor patients for benefits and harm.
"Our program improved knowledge, attitudes, confidence and clinical practice in safe opioid prescribing," explained corresponding author Daniel Alford, MD, associate professor of medicine and assistant dean at Boston University School of Medicine and course director of the SCOPE of Pain program.
While SCOPE of Pain improved clinician-level safe opioid prescribing outcomes, its impact on mitigating opioid misuse risk and harm while maintaining access to opioids for those who are or would benefit remains an unanswered question according to the researchers. "While education cannot be the only strategy to combat this national crisis, it can help improve clinician behaviors and be a major part of the solution," added Alford who is also the medical director of the Office-Based Opioid Treatment (OBOT) at Boston Medical Center.
INFORMATION:
The SCOPE of Pain program was funded by an independent educational grant awarded by the manufacturers of extended-release and long-acting opioid analgesics, collectively known as the Risk Evaluation and Mitigation Strategy (REMS) Program Companies or RPC. Boston University School of Medicine partnered with the Federation of State Medical Boards and the Council of Medical Specialty Societies in the development, execution and promotion of the SCOPE of Pain program.
The great escape: why awareness of our own mortality can be bad for our health
People with low self-esteem use a variety of escape mechanisms to avoid thinking about their own mortality, new research reveals.
Researchers led by Dr Arnaud Wisman, of the University of Kent's School of Psychology, found evidence in five studies that people with low self-esteem respond to reminders of their own mortality by directing their focus away from the 'self'.
The research found an empirical and causal link between people with low self-esteem having unconscious concerns about ...
This news release is available in German. An LMU team has shown that the axons of auditory neurons in the brainstem which respond to low and high-frequency sounds differ in their morphology, and that these variations correlate with differences in the speed of signal conduction.
As a rule, the axons (i.e. signal-transmitting fibers) of the neurons in the central nervous systems of vertebrates are ensheathed in layers of myelin, which serves as a form of insulation that improves their electrical conduction properties. In fact, the fat-rich myelin coating largely consists ...
Rehabilitation is recommended for many patients following a hospital stay for acute heart disease. In a recent original article in Deutsches Ärzteblatt International (Dtsch Arztebl int 112: 527-34) Axel Schlitt et al. show that this improves prognosis for heart disease and can thus reduce patient mortality.
More than 1900 patients in Saxony-Anhalt were contacted and asked to fill out a questionnaire. They had spent time in the hospital for serious cardiovascular disease an average of 11 years earlier. The authors used the data to analyze how many of the patients who ...
Cholecystectomy and treatment for inguinal, femoral, umbilical, or abdominal hernia are common surgeries and are considered routine in Germany. In an original article in the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 112: 535-43), Ulrike Nimptsch and Thomas Mansky show that fewer than 0.5% of patients die as a result of such surgeries. However, in those who do die risks are frequently apparent even before surgery.
Between 2009 and 2013, 731 000 cholecystectomies and 1 023 000 herniotomies took place in Germany. Over 2400 of the patients ...
This news release is available in Spanish. The behaviour involving rejection of new foodstuffs is a typical phase in infant development, above all in 2- to 3-year-olds and which subsides around the age of 5. The children who go through dietary neophobia also display signs of anguish and anxiety and this behaviour may even turn into a habit in adulthood.
In her PhD thesis the researcher of the UPV/EHU's Faculty of Psychology Edurne Maiz conducted a study on 831 schoolchildren between the ages of 8 and 16. In the study she used questionnaires on infant neophobia -adapted ...
University of Alberta paleontologists have discovered a new species of lizard, named Gueragama sulamericana, in the municipality of Cruzeiro do Oeste in Southern Brazil in the rock outcrops of a Late Cretaceous desert, dated approximately 80 million years ago.
"The roughly 1700 species of iguanas are almost without exception restricted to the New World, primarily the Southern United States down to the tip of South America," says Michael Caldwell, biological sciences professor from the University of Alberta and one of the study's authors. Oddly however, iguanas closest ...
The humble dust collecting in the average American household harbors a teeming menagerie of bacteria and fungi, and as researchers from the University of Colorado Boulder and North Carolina State University have discovered, it may be able to predict not only the geographic region of a given home, but the gender ratio of the occupants and the presence of a pet as well.
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Dutch research shows that trained detectives of specialized observation teams are much better at registering details of a drug deal than ordinary civilians. Previous legal-psychological research revealed no relevant differences in observation skills between police professionals and civilians. The findings have been published in Legal and Criminological Psychology.
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Only one in five gay and bisexual teen boys have been tested for HIV
HIV infections are on the rise for young men who have sex with men
Text messages, online program can identify nearby confidential testing sites
Testing in schools would 'normalize' the process.
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On the coral reef, knowing who's your friend and who's your enemy can sometimes be a little complicated.
Take seaweed, for instance. Normally it's the enemy of coral, secreting toxic chemicals, blocking the sunlight, and damaging coral with its rough surfaces. But when hordes of hungry crown-of-thorns sea stars invade the reef, everything changes, reports a study to be published August 25 in the journal Proceedings of the Royal Society B.
Seaweeds appear to protect coral from the marauding sea stars, giving new meaning to the proverb: "The enemy of my enemy is my friend." ...
