178 Background: The American Society of Clinical Oncology considers palliative care an integral part of cancer therapy. Our Hematology and Oncology fellowship at the University of Arkansas for Medical Sciences (UAMS) began a year-long palliative care curriculum to improve symptom management education. In this pilot study we evaluate fellows’ attitude and knowledge in cancer pain management before and after implementing a pain management curriculum. Methods: Hematology and Oncology Fellows were divided into three groups. Each group delivered a one hour lecture in pain management for a total of 3 didactic lectures. We adopted “Evidence based Practice of Palliative Medicine by Goldstein and Morrison” as the main textbook. Fellows answered a 30 item questionnaire to address attitudes and knowledge in pain management. Answers were scored using a 5 point Likert scale (1 = strongly disagree and 5 = strongly agree). Results: 11 fellows participated; six males, five females, median age 34 (R 28-40), one US graduate, and ten foreign graduates. More fellows felt comfortable managing acute (M = 4.3, SD = 0.48) compared to chronic (M = 3.8, SD 0.78) cancer related pain. Most believe that if they were taught the principle of pain management they would feel more comfortable managing pain (M = 4.6, SD = 0.51). Post pain management module, there was a statistically significant improvement in fellow’s knowledge in pain management in the setting of renal failure (P = 0.02) and bone pain (P = 0.006), and a trend towards statistically significant in both opioid rotation and conversion (P = 0.06). Fellows did poorly on opioid-drugs interaction and management of neuropathic pain. Fellows valued palliative medicine service as a great resource for their patients but most believe that they should not refer all their patients to palliative medicine for pain management. Conclusions: Pain management skills are eroding among Oncology fellows and efforts should be made to enhance symptom and pain management education in oncology training programs. This curriculum improved knowledge and self-efficacy in pain management and revealed areas for further improvement. More research is needed to address whether fellows use and apply pain management skills in the clinical setting.
Survey of Opioid Stewardship Practices in American Society of Health-System Pharmacists (ASHP) Post-Graduate Year 2 (PGY2) Pain Management and Palliative Care (PMPC) Pharmacy Residency Programs
