Multimodal Local Opioid Prescribing Intervention Outcomes in Chronic Noncancer Pain Management

Arizmendez, Natalia; Kotovicz, Fabiana; Kram, Jessica J. F.; Baumgardner, Dennis J

doi:10.3122/jabfm.2019.04.180296

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…And, is it possible to improve opioid prescribing practices through use of a multicomponent educational intervention? Arizmendez et al 16 report a study of 2 clinics with a majority of patients seen by residents. Thankfully, the article includes specific handouts that can be used for provider training.…”

Section: Substance Usementioning

confidence: 99%

Implementing Practice Changes in Family Medicine to Enhance Care and Prevent Disease Progression

Bowman¹,

Seehusen

Neale³

2019

J Am Board Fam Med

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This issue epitomizes family medicine with a heavy emphasis on research to prevent illness and illness progression. Which patients will experience significant symptomatic knee osteoarthritis? Do the elderly use retail clinics, and what is the impact on care for chronic conditions? Does capitation payment enhance or decrease same-day access? How do primary care practices risk stratify to provide integrated care? Can risk screening and on-site providers enhance psychiatric care? What screening questions should we ask adolescents, to identify problematic drug use? A report on a practice intervention to improve opioid prescribing practices, and another on the significant level of depression in many patients taking opioid medications. Which works better for smoking cessation-e-cigarettes or nicotine gum? Reminders about teratogenic drugs and those that cause hyperpigmentation. Interdisciplinary care with pharmacists in the office does not help just the patients. We have several articles on diabetes-early diagnosis, and consideration of screening for prediabetes as a quality standard-with added commentaries about this possibility. (J Am Board Fam Med 2019;32:451-453.

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Section: Substance Usementioning

confidence: 99%

Implementing Practice Changes in Family Medicine to Enhance Care and Prevent Disease Progression

Bowman¹,

Seehusen

Neale³

2019

J Am Board Fam Med

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“…7,8 Other interventions have been studied in the past, but none have explored the qualitative and quantitative value of an interdisciplinary peer-review intervention in a residency program context. [9][10][11] We developed a peer-review opioid prescribing educational intervention in a family medicine residency program, incorporating guided instruction, and examined its impact on chronic opioid prescribing practices.…”

mentioning

confidence: 99%

Evaluation of a Residency Peer-to-Peer Intervention in Opioid Prescribing

Aquino

Ottney

Odom

et al. 2022

Fam Med

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Background and Objectives: Family physicians play a crucial role in addressing the opioid epidemic. We studied a novel peer-review opioid prescribing educational intervention for family medicine residents that incorporates guided instruction from an interdisciplinary care team. Methods: We used a mixed-methods study design in the setting of a family medicine residency program in the Midwestern United States. Residents participated in small group, peer-to-peer discussions of patients chronically prescribed opioids with guidance and input from faculty, a pharmacist, and pharmacy students. Discussions followed a structured approach to evaluation based on guidelines, and written recommendations were given to the patients’ resident primary care physician (PCP). For each patient, we reviewed electronic medical records to assess whether PCPs implemented the written recommendations. We used one-way analyses of variance to determine the statistical significance of changes made. The principal investigator interviewed seven participating residents to survey their satisfaction with the curriculum and collated suggestions for improvement. Results: Over a 3-year period, we reviewed 59 patients as part of the intervention; of these, 53 had complete records reviewed for this study. Patients’ morphine milligram equivalent dosage (MME) declined modestly (P=.035). The number and proportion of recommendations implemented was correlated with the decline in MME (P=.004 and P=.013, respectively). Interviewed residents unanimously evaluated the curriculum positively, citing that the structured approach helped align their practices with guidelines. Conclusions: The guided peer-review intervention effectively decreased chronic opioid use among patients, and residents positively evaluated the curriculum.

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