Development and pilot evaluation of an educational session to support sparing opioid prescriptions to opioid naïve patients in a Canadian primary care setting.
audit and feedback
educational evaluation
opioids
pain management
primary care
Journal
Family practice
ISSN: 1460-2229
Titre abrégé: Fam Pract
Pays: England
ID NLM: 8500875
Informations de publication
Date de publication:
22 11 2022
22 11 2022
Historique:
pubmed:
12
5
2022
medline:
25
11
2022
entrez:
11
5
2022
Statut:
ppublish
Résumé
Prescribing rates of some analgesics decreased during the public health crisis. Yet, up to a quarter of opioid-naïve persons prescribed opioids for noncancer pain develop prescription opioid use disorder. We, therefore, sought to evaluate a pilot educational session to support primary care-based sparing of opioid analgesics for noncancer pain among opioid-naïve patients in British Columbia (BC). Therapeutics Initiative in BC has launched an audit and feedback intervention. Individual prescribing portraits were mailed to opioid prescribers, followed by academic detailing webinars. The webinars' learning outcomes included defining the terms opioid naïve and opioid sparing, and educating attendees on the (lack of) evidence for opioid analgesics to treat noncancer pain. The primary outcome was change in knowledge measured by four multiple-choice questions at the outset and conclusion of the webinar. Two hundred participants attended four webinars; 124 (62%) responded to the knowledge questions. Community-based primary care professionals (80/65%) from mostly urban settings (77/62%) self-identified as family physicians (46/37%), residents (22/18%), nurse practitioners (24/19%), and others (32/26%). Twelve participants (10%) recalled receiving the individualized portraits. While the correct identification of opioid naïve definitions increased by 23%, the correct identification of opioid sparing declined by 7%. Knowledge of the gaps in high-quality evidence supporting opioid analgesics and risk tools increased by 26% and 35%, respectively. The educational session outlined in this pilot yielded mixed results but appeared acceptable to learners and may need further refinement to become a feasible way to train professionals to help tackle the current toxic drugs crisis.
Sections du résumé
BACKGROUND
Prescribing rates of some analgesics decreased during the public health crisis. Yet, up to a quarter of opioid-naïve persons prescribed opioids for noncancer pain develop prescription opioid use disorder. We, therefore, sought to evaluate a pilot educational session to support primary care-based sparing of opioid analgesics for noncancer pain among opioid-naïve patients in British Columbia (BC).
METHODS
Therapeutics Initiative in BC has launched an audit and feedback intervention. Individual prescribing portraits were mailed to opioid prescribers, followed by academic detailing webinars. The webinars' learning outcomes included defining the terms opioid naïve and opioid sparing, and educating attendees on the (lack of) evidence for opioid analgesics to treat noncancer pain. The primary outcome was change in knowledge measured by four multiple-choice questions at the outset and conclusion of the webinar.
RESULTS
Two hundred participants attended four webinars; 124 (62%) responded to the knowledge questions. Community-based primary care professionals (80/65%) from mostly urban settings (77/62%) self-identified as family physicians (46/37%), residents (22/18%), nurse practitioners (24/19%), and others (32/26%). Twelve participants (10%) recalled receiving the individualized portraits. While the correct identification of opioid naïve definitions increased by 23%, the correct identification of opioid sparing declined by 7%. Knowledge of the gaps in high-quality evidence supporting opioid analgesics and risk tools increased by 26% and 35%, respectively.
CONCLUSION
The educational session outlined in this pilot yielded mixed results but appeared acceptable to learners and may need further refinement to become a feasible way to train professionals to help tackle the current toxic drugs crisis.
Identifiants
pubmed: 35543305
pii: 6583564
doi: 10.1093/fampra/cmac044
pmc: PMC9680661
doi:
Substances chimiques
Analgesics, Opioid
0
Banques de données
ISRCTN
['ISRCTN34246811']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1024-1030Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
Drug Alcohol Depend. 2021 Oct 1;227:108989
pubmed: 34482045
Med Educ. 2010 Nov;44(11):1057-68
pubmed: 20946476
Qual Health Res. 2005 Nov;15(9):1277-88
pubmed: 16204405
Can J Anaesth. 2022 Aug;69(8):1007-1016
pubmed: 34750746
Cureus. 2020 Apr 22;12(4):e7778
pubmed: 32455084
J Addict Med. 2022 Jul-Aug 01;16(4):386-388
pubmed: 34690337
Lancet. 1998 Sep 19;352(9132):943-8
pubmed: 9752816
MMWR Morb Mortal Wkly Rep. 2021 Nov 26;70(47):1649-1651
pubmed: 34818316
Lancet. 2022 Feb 5;399(10324):555-604
pubmed: 35122753
BMJ. 2000 Sep 16;321(7262):694-6
pubmed: 10987780
J Contin Educ Health Prof. 2012 Summer;32(3):153-62
pubmed: 23008077
CMAJ Open. 2021 May 6;9(2):E466-E473
pubmed: 33958382
Int J Drug Policy. 2019 Dec;74:257-265
pubmed: 30765118
Acad Med. 2019 Oct;94(10):1461-1470
pubmed: 30998575
J Pain Res. 2019 Feb 07;12:617-620
pubmed: 30799947
JAMA. 2019 Nov 19;322(19):1912-1913
pubmed: 31600370
J Subst Abuse Treat. 2019 Aug;103:58-63
pubmed: 31079950
Implement Sci. 2014 Jan 17;9:14
pubmed: 24438584
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
Implement Sci. 2021 Feb 17;16(1):19
pubmed: 33596946
Acad Med. 2022 Feb 1;97(2):286-299
pubmed: 34074902
J Gen Intern Med. 2014 Nov;29(11):1534-41
pubmed: 24965281
MMWR Morb Mortal Wkly Rep. 2021 Dec 17;70(50):1740-1746
pubmed: 34914673
Fam Pract. 2004 Oct;21(5):575-81
pubmed: 15367481
Ann Fam Med. 2019 Mar;17(2):116-124
pubmed: 30858254
JAMA Netw Open. 2019 Aug 2;2(8):e1910373
pubmed: 31469396
Ann Intern Med. 2019 May 7;170(9):665-666
pubmed: 31060064
J Pharm Policy Pract. 2020 Oct 23;13:68
pubmed: 33110608
Br J Gen Pract. 2021 Sep 30;71(711):e788-e796
pubmed: 33979300
Contemp Clin Trials. 2021 Aug;107:106462
pubmed: 34082074
JAMA Netw Open. 2019 May 3;2(5):e193365
pubmed: 31050783
Br J Gen Pract. 2017 Jul;67(660):310
pubmed: 28663419
N Engl J Med. 2018 Jul 5;379(1):7-8
pubmed: 29972744