The Development of an Opioid Misuse Training Program for Physical Therapists: A Learning Community Approach.
Journal
Journal, physical therapy education
ISSN: 1938-3533
Titre abrégé: J Phys Ther Educ
Pays: United States
ID NLM: 9306054
Informations de publication
Date de publication:
14 May 2024
14 May 2024
Historique:
received:
20
06
2023
accepted:
02
02
2024
medline:
13
5
2024
pubmed:
13
5
2024
entrez:
13
5
2024
Statut:
aheadofprint
Résumé
Musculoskeletal pain and opioid misuse frequently co-occur. The US Preventive Services Task Force calls for all health care providers to be trained to screen for misuse and/or opioid use disorder. The purpose of this study was to develop and implement an opioid misuse training program that could be used by physical therapists. Thirteen practicing physical therapists were invited to participate in a curriculum development project. Using the Curriculum Framework, a collaborative learning approach was used to develop an opioid misuse training program and training manual for physical therapists. Four training sessions were provided virtually every 2 weeks. Topics included an introduction to the opioid crisis, screening, assessing, and communicating with patients and with the health care team about opioid misuse. Each didactic session was followed by a participant feedback session where participants provided recommendations on improving the training content and their impressions on the barriers and facilitators to incorporating the training into practice. A companion training manual was created and sent to participants for comment. Participants were asked over email to describe whether and how they incorporated training materials into clinical practice during the training curriculum. All participants attended sessions 1-3. Twelve (92.3%) attended the fourth session. Based on the participants' feedback, training sessions were edited, and a companion training manual was finalized and distributed to each participant. After the fourth session, 9 participants (69.2%) reported using what they learned in the training. During the participant feedback sessions, participants regarded the training as important. Some participants expressed barriers to discussing opioids with patients and concerns about whether the training was within physical therapists' scope of practice. An iteratively developed training program for physical therapists to address opioid misuse was acceptable, feasible, and provided immediate practice change by most participants.
Identifiants
pubmed: 38739432
doi: 10.1097/JTE.0000000000000343
pii: 00001416-990000000-00109
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NCCIH NIH HHS
ID : 3KL2TR002539-04S1
Pays : United States
Informations de copyright
Copyright © 2024 Academy of Physical Therapy Education, APTA.
Références
Department of Health and Human Services. National opioids crisis: Help and resources. In: Opioid Facts and Statistics 2022. https://www.hhs.gov/opioids/statistics/index.html. Accessed November 11, 2023.
Substance Use and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United Sates: Results From the 2020 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2021:25-30.
Ahmad FB, Cisewski JA, Rossen LM, Suttorn P. Provisional Drug Overdose Death Counts; 2023. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm. Accessed Feburary 9, 2023.
Han B, Compton WM, Blanco C, Crane E, Lee J, Jones CM. Prescription opioid use, misuse, and use disorders in U.S. adults: 2015 national survey on drug use and health. Ann Intern Med. 2017;167:293-301.
Magel J, Kietrys D, Kruger ES, Fritz JM, Gordon AJ. Physical therapists should play a greater role in managing patients with opioid use and opioid misuse. Subst Abus. 2021;42:255-260.
Morasco BJ, Yarborough BJ, Smith NX, et al. Higher prescription opioid dose is associated with worse patient-reported pain outcomes and more health care utilization. J Pain. 2017;18:437-445.
Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain: United States, 2016. JAMA. 2016;315:1624-1645.
Centers for Disease Control and Prevention. CDC Guidelines for Prescribing Opioids for Chronic Pain; 2019. https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm?s_cid=rr7103a1.htm_w. Accessed March 23, 2023.
Delitto A, George SZ, Van Dillen LR, et al. Low back pain. J Orthop Sports Phys Ther. 2012;42:A1-A57.
Cibulka MT, White DM, Woehrle J, et al. Hip pain and mobility deficits: Hip osteoarthritis: Clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2009;39:A1-A25.
Carter SK, Rizzo JA. Use of outpatient physical therapy services by people with musculoskeletal conditions. Phys Ther. 2007;87:497-512.
Zheng P, Kao MC, Karayannis NV, Smuck M. Stagnant physical therapy referral rates alongside rising opioid prescription rates in patients with low back pain in the United States 1997-2010. Spine (Phila Pa 1976). 2017;42:670-674.
Khoja SS, Almeida GJ, Freburger JK. Recommendation rates for physical therapy, lifestyle counseling, and pain medications for managing knee osteoarthritis in ambulatory care settings: A cross-sectional analysis of the national ambulatory care survey (2007-2015). Arthritis Care Res. 2020;72:184-192.
Magel J, Kim J, Fritz JM, Freburger JK. Time between an emergency department visit and initiation of physical therapist intervention: Health care utilization and costs. Phys Ther. 2020;100:1782-1792.
Childs JD, Fritz JM, Wu SS, et al. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res. 2015;15:150.
Lieberz D, Regal R, Conway P. Observational study: Predictors of a successful functional outcome in persons who receive physical therapy for knee osteoarthritis. Eval Health Prof. 2020:163278720954229.
U.S. Preventive Services Task Force. Unhealthy Drug Use: Screening; 2020. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/drug-use-illicit-screening. Accessed February 7, 2024.
Gordon AJ, Broyles LM. A physician-centered approach to addiction identification and treatment misses the opportunity for interdisciplinary solutions. Subst Abus. 2014;35:108-109.
Screening for unhealthy drug use: Recommendation statement. Am Fam Physician. 2021;103:107-112.
National Institute on Drug Abuse. Screening for Drug Use in General Medical Settings. Bethesda, MD: National Institutes of Health; 2012.
Davenport TE, DeVoght AC, Sisneros H, Bezruchka S. Navigating the intersection between persistent pain and the opioid crisis: Population health perspectives for physical therapy. Phys Ther. 2020;100:995-1007.
Broyles LM, Gordon AJ. SBIRT implementation: Moving beyond the interdisciplinary rhetoric. Subst Abus. 2010;31:221-223.
Barata IA, Shandro JR, Montgomery M, et al. Effectiveness of SBIRT for alcohol use disorders in the emergency department: A systematic review. West J Emerg Med. 2017;18:1143-1152.
Montag A, Clapp JD, Calac D, Gorman J, Chambers C. A review of evidence-based approaches for reduction of alcohol consumption in native women who are pregnant or of reproductive age. Am J Drug Alcohol Abuse. 2012;38:436-443.
Reho K, Agley J, DeSalle M, Gassman RA. Are we there yet? A review of screening, brief intervention, and referral to treatment (SBIRT) implementation fidelity tools and proficiency checklists. J Prim Prev. 2016;37:377-388.
Yuma-Guerrero PJ, Lawson KA, Velasquez MM, von Sternberg K, Maxson T, Garcia N. Screening, brief intervention, and referral for alcohol use in adolescents: A systematic review. Pediatrics. 2012;130:115-122.
Scudder AT, Bucey JC, Loughran MJ, et al. Screening, brief intervention, and referral to treatment (SBIRT) expansion of training to non-physician healthcare graduate students: Counseling psychology, nursing, occupational therapy, physical therapy, and physician assistant studies. Subst Abus. 2019:1-11.
Magel JJ, Cochran G, West N, Fritz JM, Bishop MD, Gordon AJ. Physical therapists' attitudes are associated with their confidence in and the frequency with which they engage in prescription opioid medication misuse management practices with their patients. A cross-sectional study. Subst Abus. 2022;43:433-441.
Magel J, Hartman P, Fritz JM, et al. Patients' perceptions of physical therapists addressing opioid misuse. Subst Abus. 2023;44:32-40.
American Physical Therapy Association. Pharmacology in Physical Therapy Practice. Vol HOD P06-18-34-39. Alexandria VA: American Physical Therapy Association; 2018.
Adademy of Geriatric Physical Therapy. Essential competencies in the care of older adults at the completion of the entry-level physical therapist professional program of study. J Phys Ther Educ. 2014;28:91-93.
Man LC, DiCarlo M, Lambert E, et al. A learning community approach to identifying interventions in health systems to reduce colorectal cancer screening disparities. Prev Med Rep. 2018;12:227-232.
Center on the Developing Child. Learning Communities. https://developingchild.harvard.edu/collective-change/key-concepts/learning-communities/. Accessed February 7, 2024.
Allan J, Barwick TA, Cashman S, et al. Clinical prevention and population health: Curriculum framework for health professions. Am J Prev Med. 2004;27:471-476.
Tilley DS, Boswell C, Cannon S. Developing and establishing online student learning communities. Comput Inform Nurs. 2006;24:144-151; quiz 150-141.
Carpenter D, Hassell S, Mardon R, et al. Using learning communities to support adoption of health care innovations. Joint Comm J Qual Patient Saf. 2018;44:566-573.
Perry C, Liberto J, Milliken C, et al. The management of substance use disorders: Synopsis of the 2021 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Ann Intern Med. 2022;175:720-731.
Wyse JJ, Gordon AJ, Dobscha SK, et al. Medications for opioid use disorder in the Department of Veterans Affairs (VA) health care system: Historical perspective, lessons learned, and next steps. Subst Abus. 2018;39:139-144.
Gordon AJ, Liberto J, Granda S, Salmon-Cox S, Andree T, McNicholas L. Outcomes of DATA 2000 certification trainings for the provision of buprenorphine treatment in the Veterans Health Administration. Am J Addict. 2008;17:459-462.
Gordon AJ, Kenny M, Dungan M, et al. Are x-waiver trainings enough? Facilitators and barriers to buprenorphine prescribing after x-waiver trainings. Am J Addict. 2022;31:152-158.
Gordon AJ, Drexler K, Hawkins EJ, et al. Stepped care for opioid use disorder train the trainer (SCOUTT) initiative: Expanding access to medication treatment for opioid use disorder within Veterans Health Administration facilities. Subst Abus. 2020;41:275-282.
Kampman K, Jarvis M. American society of addiction medicine (ASAM) national practice guideline for the use of medications in the treatment of addiction involving opioid use. J Addict Med. 2015;9:358-367.
Magel JS, Gordon AJ, Fritz JM, Kim J. The influence of an opioid use disorder on initiating physical therapy for low back pain: A retrospective cohort. J Addict Med. 2021;15:226-232.
Magel J, Bishop MD, Lonnemann E, et al. The association between advanced orthopedic certification and confidence and engagement in prescription opioid medication misuse management practices: A cross-sectional study. J Man Manip Ther. 2022;30:228-238.
Fritz JM, Sharpe J, Greene T, et al. Optimization of spinal manipulative therapy protocols: A factorial randomized trial within a multiphase optimization framework. J Pain. 2021;22:655-668.
Fritz JM, Magel JS, McFadden M, et al. Early physical therapy vs usual care in patients with recent-onset low back pain: A randomized clinical trial. JAMA. 2015;314:1459-1467.
Siantz E, Henwood B, Gilmer T. Patient experience with a large-scale integrated behavioral health and primary care initiative: A qualitative study. Fam Syst Health. 2020;38:289-299.
Siantz E, Henwood B, Rabin B, Center K, Fenwick K, Gilmer T. A mixed-method evaluation of the behavioral health integration and complex care initiative using the consolidated framework for implementation research. Med Care. 2021;59:632-638.
Sullivan MD, Edlund MJ, Fan MY, Devries A, Braden JB, Martin BC. Risks for possible and probable opioid misuse among recipients of chronic opioid therapy in commercial and medicaid insurance plans: The TROUP Study. Pain. 2010;150:332-339.
American physical Therapy Association. Beyond Opioids: How Physical Therapy Transforms Pain Management To Improve Health: 2021. APTA; 2021.
The Commission on Accreditation in Physical Therapy Education. Standards and Required Elements for Accreditation of Physical Therapist Education Programs. https://www.capteonline.org/. Accessed February 27, 2023.
Boyatzis R. Transforming Qualitative Information: Thematic Analysis and Code Development. Thuosand Oaks, CA: Sage; 1998.