scholarly journals Impact of an Educational Intervention on the Opioid Knowledge and Prescribing Behaviors of Resident Physicians

Author(s):  
Pankti P. Acharya ◽  
Brianna Fram ◽  
Jenna R. Adalbert ◽  
Ashima Oza ◽  
Prashanth Palvannan ◽  
...  

Abstract Background The opioid epidemic is a multifactorial issue, which includes pain mismanagement. A recent study has shown that residents have received little training for opioid related patient care. Therefore, resident physician education is essential in addressing this issue. We aimed to analyze the effects of an educational intervention on the knowledge and potential prescribing habits of emergency medicine, general surgery, and internal medicine residents. Methods Resident physicians were provided with educational materials and were given pre- and posttests to complete. Descriptive statistics were used to analyze pre- and posttest responses. Chi-squared analysis was used to identify changes between the pre and posttests. A p < 0.05 value was considered statistically significant. Results Following the educational intervention, we observed improvement in correct prescribing habits for acute migraine management among emergency medicine residents (from 14.8–38.5%). Among general surgery residents, there was significant improvement in adherence to narcotic amounts determined by recent studies for sleeve gastrectomy (p = 0.01) and laparoscopic cholecystectomy (p = 0.002). Additionally, we observed a decrease in the number of residents who would use opioids as a first line treatment for migraines, arthritic joint pain, and nephrolithiasis. Conclusions Resident physicians have an essential role in combating the opioid epidemic. There was significant improvement in various aspects of opioid related pain management among emergency medicine, internal medicine, and general surgery residents following the educational interventions. We recommend that medical school and residency programs consider including opioid related pain management in their curricula.

2020 ◽  
Vol 251 ◽  
pp. 6-15 ◽  
Author(s):  
BrookeAnne Magrum ◽  
Kristin Brower ◽  
Daniel Eiferman ◽  
Chelsea Horwood ◽  
Michelle Nguyen ◽  
...  

2005 ◽  
Vol 1 (2) ◽  
pp. 98 ◽  
Author(s):  
Mark Chaitowitz, MBBCh ◽  
William Tester, MD ◽  
Glenn Eiger, MD

Deficiencies in practice, knowledge, and competence among physicians are important contributing factors to the unsatisfactory level of analgesic care in hospitalized patients. By way of a comprehensive survey, we characterized these deficiencies within an internal medicine residency program as an initial step in designing remedial educational strategies. To do so, an anonymous 43-item survey was administered to residents in an internal medicine program. A total of 61 residents (69 percent) responded.The results indicated that patient-controlled analgesia (PCA), a standardized pain scale, and an opioid equivalence table were underused. Competence in opioid conversion was suboptimal, but completion of an oncology rotation and familiarity with the opioid equivalence table predicted greater competence in this area (p = 0.007 and p = 0.001, respectively).Self-perceptions of adequacy of training and painmanagement competence were predictors of knowledge (p = 0.026 and p = 0.038, respectively). Attitudes regarding opioid analgesia were generally satisfactory (i.e., low “opiophobia” score), although the risk of addiction was still overestimated.The characterization of deficiencies in pain management in a residency program is an essential step in the design and implementation of educational interventions. Administration of a comprehensive survey is a simple and effective method of gathering this data and has the additional benefit of promoting awareness of pain management issues. Our experience served to establish, among other findings, the didactic value of experience on an oncology floor; this result substantiates the value of practical experience in the gaining of clinical competence in pain management. Interventions that capitalize on the findings of the survey and the interest in pain management generated by its administration are currently ongoing at our institution.


Author(s):  
maayan ben sasson ◽  
Ofir Hagalili ◽  
Elad Schiff ◽  
Samuel Attias ◽  
Simon Vulfsons

Introduction: the Pain management in internal medicine ward is a common problem. Studies have shown that the evaluation of pain and its documentation by the medical staff is inaccurate and tends to underestimate the level of pain reported by patients. In addition, Physicians often report lack of knowledge and misconceptions regarding pain management. Objectives: To assess the impact of a structured pain educational program on knowledge, skills and abilities [KSA’s] of internal medicine ward physicians in pain management. Methods: Eleven physicians from Internal medicine ward B at Bnai-Zion Medical Center, a tertiary academic center in Israel, participated in a pain educational program. Questioners regarding pain KSA’s, were completed before and after the educational intervention. Concomitantly, a pain management protocol was implemented in the department. Results: There was a 55.5% (P.value = 0.003) improvement in the overall satisfaction of the physicians regarding pain management in the internal ward on a 1 to 6 Likert scale (1-strongly disagree, 6-strongly agree) .In a modified KnowPain50 [KP50] questionnaire that assesses physicians KSA, the average score for all physicians improved by 15.3% (P.value = 0.012) after the intervention. Conclusion: A targeted educational intervention on pain management can improve physician’s KSA, and this we belive may lead to a better treatment for patients suffering from pain in the hospital scenerio.


2014 ◽  
Vol 69 (1) ◽  
pp. 33-40 ◽  
Author(s):  
G. Civardi ◽  
F. Zucco ◽  
A. Valerio ◽  
A. Fontanella ◽  
M. Alessandri ◽  
...  

2019 ◽  
Vol 35 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Henry Zeng ◽  
Paul Eugene ◽  
Mark Supino

Background: There is a growing movement to increase palliative care consults from the emergency department (ED) to reduce healthcare costs and improve quality of life. The surprise question is a screening tool that emergency medicine physicians may be able to use towards achieving this goal. Objective: The objectives of this study were to increase awareness of hospice and palliative care medicine (HPM) among emergency medicine (EM) providers and to evaluate whether this heightened awareness increased palliative care consults among participating emergency medicine providers. Methods: We conducted an anonymous convenience sample survey and two educational interventions about HPM including the surprise question among emergency medicine resident and attending physicians at a large urban public academic quaternary care center from July to November 2018. A report of palliative care consults ordered between August 1, 2017 and January 1, 2019 was generated from the electronic health records used by the hospital. The number of palliative care consults made before and after the educational intervention was compared. Results: After the first educational intervention centered on the surprise question, palliative care consults from the ED increased from an average of 2.25 per month (range 0 to 8, SD: 2.38) to 12.67 per month (range 9 to 19, SD: 4.01, p < .001). Conclusion: Educating EM physicians about the surprise question can increase the number of palliative care consults from the ED, thereby potentially improving patient care and decreasing costs by avoiding unwanted healthcare interventions.


2018 ◽  
Vol 21 (10) ◽  
pp. 1378-1379
Author(s):  
Jason K. Bowman ◽  
Emily L. Aaronson ◽  
Naomi R. George ◽  
Corinne Alexander Cole ◽  
Kei Ouchi

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Andrew Lai ◽  
Amy Odom ◽  
Steven E. Roskos ◽  
Julie P. Phillips

Introduction: Proton pump inhibitors (PPIs) are often prescribed beyond their medically-approved duration of use. Long-term PPI use has been linked with numerous adverse effects and contributes to polypharmacy. This study sought to understand the effect of evidence-based education to resident and faculty physicians on deprescribing inappropriate PPIs. We hypothesized that this educational intervention would result in fewer inappropriate PPI prescriptions. Methods: We performed a chart review on all adult patients in a family medicine residency program practice, identifying those inappropriately taking PPIs. All physicians in the practice participated in an educational intervention regarding deprescribing inappropriate PPIs and were given frequent reminders to continue their deprescribing efforts. We reviewed charts at the end of the study to identify patients with successful deprescribing attempts. Results: Of the 187 patients prescribed inappropriate PPIs in the study, 100 remained on PPIs at the end of the study (46.6% success rate). There was a significant decrease in the number of patients inappropriately prescribed PPIs by each physician over the course of the study, from a mean of 17.0 (beginning) to 9.1 (end). Conclusion: Physician education with reminders is an effective means of reducing the number of inappropriate PPIs prescribed in a family medicine residency practice. Future studies could investigate the effectiveness of educational interventions with other medication classes that are often prescribed inappropriately.


2016 ◽  
Vol 2 (3) ◽  
Author(s):  
Marco Antônio Guimarães Da Silva

Por circunstâncias relacionadas à minha titulação, acabei designado pela Universidade Castelo Branco do Rio de Janeiro (UCB) para avaliar uma parceria proposta pela Escola de Osteopatia de Madri (EOM). À época, em 1997, a EOM propunha que a UCB passasse a organizar academicamente os cursos de osteopatia que a referida Escola já vinha ministrando no Brasil, com vistas a, no futuro, torná-lo um curso de pós-graduação. Algumas viagens à Madri para observar a estrutura acadêmica e pedagógica da sede da EOM, condição imposta pela UCB para concretizar a parceria, me levaram a conhecer esta modalidade terapêutica, com resultados efetivamente comprovados através de trabalhos científicos.Realizadas as adaptações que se faziam necessárias, a UCB aprovou, em 2000, o curso de osteopatia, com uma carga horária de 1050 horas para a titulação de especialização acadêmica, nível Lato Sensu. A resolução do COFITO, que estabelece a osteopatia como uma especialidade da fisioterapia, levou-nos a propor ao CEPE da UCB uma complementação de 450 horas, alcançando, assim, as 1.500 horas, distribuídas ao longo de cinco anos, exigidas pela referida resolução do COFITO. A introdução desta técnica terapêutica no Brasil pela corrente Européia e a pronta intervenção do COFITO foram fatores decisivos para nos brindar com mais uma especialidade. Houvera sido a Osteopatia implantada no Brasil por influência da escola americana, talvez os rumos tomados fossem outros. Senão, vejamos. Nos EUA, a osteopatia é normalmente exercida pelo médico, que deve obter sua permissão através do National Board of Osteopatic Medical Examiners, e está dividida em Sociedades Osteopáticas que se distribuem por todas as modalidades médicas; a saber: Allergy and Immunology, Anesthesiology, Dermatology ,Emergency Medicine, Internal Medicine, Neurologists and Psychiatrists, Obstetrics and Gynecology, Occupational and Preventive Medicine, Ophthalmology and Otolaryngology, Orthopedics Pathology, Pediatrics Proctology, Radiology, Physical Medicine and Rehabilitation, Rheumatology Sports Surgery Medicine.Com o objetivo de incentivar as linhas de pesquisas na área da osteopatia, estará sendo criado, durante as III Jornadas Hispano-Lusas de Fisioterapia em Terapia Manual (Sevilha-Espanha, 5 de outubro de 2001), o Centro Internacional de Pesquisas em Osteopatia. O referido Centro, dirigido por um fisioterapeuta brasileiro com Doutorado, terá sua sede na Espanha e manterá núcleos, vinculados a Universidades, na Argentina, no Brasil, na Itália, em Portugal e na Venezuela. Esperamos, desta forma, ao lado do reconhecimento profissional já oferecido pela resolução COFITO, dar mais um passo na consolidação acadêmica da nossa mais nova modalidade terapêutica.


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