Changes Made By Physicians Who Misprescribed Controlled Substances

Abstract

This article describes a short-term evaluation of the behavioral and practice-related changes physicians have made as a result of attending one such course. Barriers that interfered with intended changes are described. PROGRAM DESCRIPTIONThe course's history and contents are described elsewhere. 5,7,8 Course registration is limited to no more than 12 participants. The small-group experience gives participants opportunities to vent anger at being accused of wrongdoing, to learn that they are neither alone nor being singled out by a state medical board, to examine the reasons that might underlie misprescribing, and to learn strategies for preventing recurrence.Consistent with the literature on promoting physician behavior change, the three-day course combines traditional didactic instruction, confrontation, personal examination, practical planning, and problem solving. [9][10][11][12][13] Course objectives aim to help participants: • constructively re-channel anger associated with being remanded to the course

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).…”

“…Most of these programs involved traditional live group learning, though we also noted examples of other delivery modes. Of these 9 programs, 3 mandated physician participation in the program (e.g., due to identified inappropriate prescribing), 62,63,73,74 and another mixed mandated and voluntary participants. 61 None of the programs with pharmacist regulator involvement mandated pharmacist involvement.…”

“…81 Finally, 1 traditional live, small-group program with regulatory involvement was designed around models of physician behavior change. 73…”

“…Studies of 6 programs (19%), including the 2 audit and feedback programs and 1 program that included only mailed information, did not specify the duration of the intervention. 50,59,64,70,73,74,76…”

“…Studies of 5 programs (16%) reported, instead, focusing on performance-level problems such as practices relating to opioid prescribing and chronic pain. Articles on 3 of these programs [42][43][44][45][46]73,74 published outcomes in the 1980s and 1990s, before the recognition of widespread, population-level harms from opioids. A more recent study (from 2015) was based in Turkey, 64 where the epidemiology of opioid prescribing and related harms is distinct from that of the United States and Canada.…”