An examination of the perceived impact of a continuing interprofessional education experience on opiate prescribing practices

Abstract

Chronic pain is increasingly recognized as a public health problem. We assessed the effectiveness of a multi-modal, interprofessional educational approach aimed at empowering healthcare professionals to make deliberative changes, especially in opiate prescribing practices. Education activities included enduring webcasts, regional interprofessional roundtable events, and state-level conference presentations within targeted Kentucky and West Virginia regions of the United States. Over 1,000 participants accessed the various activities. For the live events, the largest groups reached included nurses (38.1%), nurse practitioners (31.2%), and physicians (22.1%). In addition to our reach, higher levels of educational effectiveness were measured, specifically, learner's intentions to change practice patterns, confidence in meeting patient's needs, and knowledge of pain management guidelines. The majority of the conference (58%) and roundtable (69%) participants stated they intend to make a practice change in one or more areas of chronic pain patient management in post-event evaluation. Differences in pre- and post-activity responses on the measures of confidence and knowledge, with additional comparison to a control population who were not in attendance, were analyzed using non-parametric tests of significance. While neither activity produced significant changes in confidence from pre-activity, participants were more confident post-activity than their control group peers. There were significant changes in knowledge for both live event and webcast participants. Impactful chronic pain continuing the education that emphasizes collaborative care is greatly needed; these results show that the approaches taken here can impact learner's knowledge and confidence, and hold potential for creating change in how opioid prescribing is managed.

Evaluations of Continuing Health Provider Education Focused on Opioid Prescribing: A Scoping Review

“…37,38 At this stage, we also identified an additional study to include that provided more information about the delivery and development of a program described in another included study. Of the remaining 39 records, 39–77 7 reported different outcomes for programs covered in other reports, so we analyzed these with the primary record (and the denominators for the data reported below are 32 unless otherwise stated).…”

“…Of these 17, only 2 included comparator groups. 52,77 Evaluations of 6 programs 53,65,68,69,74,76 (19%) measured only postintervention outcomes without any baseline measures. The studies of 2 programs (6%) examining the effects of the educational interventions on physician prescribing used retrospective cohort studies, 50,60 and another one (3%) used a time series analysis.…”

“…These were typically delivered as standalone programs, but we also found examples of delivery at the workplace [44][45][46][47][48][49][50][51]53,59,61,64,68 or in the context of a conference. 39,52,53,65,67,69,72 Some of these traditional live group programs also provided an alternative online individual asynchronous version 39,47,48,52,[55][56][57]66,69 ; none of these blended in-person and online programs. One program, 67 which was the first to report any kind of virtual delivery of education, did blend group learning with cases emailed monthly to participants after the in-person intervention.…”

A Conceptual Framework for Continuing Medical Education and Population Health

“…In this same scoping review only seven studies explicitly described a theory, model, or framework that guided their intervention development, delivery, or evaluation. [46][47][48][49][50][51][52] Most of these were theories of individual behavior change such as the Theory of Planned Behavior or the Transtheoretic Model of Behavior Change. We did not identify use of any theories, models, or frameworks of behavior change models for population health.…”

Managing Acute Pain and Opioid Risks Following Wisdom Teeth Extraction: An Illustrative Case

“…28 Interprofessional and profession-specific journals have disseminated studies on interprofessional curricular offerings and continuing education efforts related to opioids. [29][30][31][32][33][34][35][36] Although some specialized organizations provide guidance for interprofessional opioid curricula 37 or engage students in creating interprofessional team presentations, 38 interprofessional opioid initiatives within and beyond individual institutions are not well documented. The relative scarcity of interprofessional approaches to opioid education is reflective of the current state of interprofessional education more generally, where health professional students for the most part continue to learn in silos.…”