Randomized Trial of Web-based Training About Opioid Therapy for Chronic Pain

Sullivan, Mark D.; Gaster, Barak; Russo, Joan; Bowlby, Lynn; Rocco, Nicole; Sinex, Noelle; Livovich, Jeffrey; Jasti, Harish; Arnold, Robert M.

doi:10.1097/ajp.0b013e3181dc7adc

Cited by 49 publications

(52 citation statements)

References 20 publications

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“…A combined intervention that includes information materials, decision-making support and patient education units would probably be perceived as more effective for improving patient-centeredness. Other studies in the medical setting have shown combined interventions to be effective in enhancing patient-centered care [46–48]. Moreover, it is very likely that different patient populations were asked to participate during the two data collection periods.…”

Section: Discussionmentioning

confidence: 99%

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

et al. 2017

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PurposeAlthough the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness.MethodA multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis.ResultsIn order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010–.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions.ConclusionThe TCC improved dimensions that were addressed directly by the approach and were linked to the clinics’ needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention.

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Section: Discussionmentioning

confidence: 99%

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

et al. 2017

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“…Moreover, when denying a patient's request for opioid therapy, it might prove beneficial to explicitly share one's reasoning when it pertains to concerns about their well‐being and safety. Although not in the context of evaluating chronic pain patient outcomes, randomized controlled trials of diverse communication interventions have indeed demonstrated positive effects on patient and provider communication outcomes , as well as on PCP self‐reported competence, satisfaction, and patient centeredness .…”

Section: Resultsmentioning

confidence: 99%

Contrasting Tensions Between Patients and PCPs in Chronic Pain Management: A Qualitative Study: Table 1

et al. 2013

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“…Sullivan et al 16 included depictions of clinical interactions in an interactive, Web-based training module regarding opioid therapy. Exposure to the training module, which also included standard summaries of evidence, increased physician knowledge and self-reported competence in the management of chronic noncancer pain.…”

Section: Discussionmentioning

confidence: 99%

Evidence‐based Narratives to Improve Recall of Opioid Prescribing Guidelines: A Randomized Experiment

Kilaru¹,

Perrone²,

Auriemma

et al. 2014

Academic Emergency Medicine

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Objectives Physicians adopt evidence-based guidelines with variable consistency. Narratives, or stories, offer a novel dissemination strategy for clinical recommendations. The study objective was to compare whether evidence-based narrative versus traditional summary improved recall of opioid prescribing guidelines from the American College of Emergency Physicians (ACEP). Methods This was a prospective, randomized controlled experiment to compare whether narrative versus summary promoted short-term recall of six themes contained in the ACEP opioid guideline. The experiment was modeled after the free-recall test, an established technique in studies of memory. At a regional conference, emergency physicians were randomized to read either a summary of the guideline (control) or a narrative (intervention). The fictional narrative was constructed to match the summary in content and length. One hour after reading the text, participants listed all content that they could recall. Two reviewers independently scored the responses to assess recall of the six themes. The primary outcome was the total number of themes recalled per participant. Secondary outcomes included the proportion of responses in each study arm that recalled individual themes and the proportion of responses in each arm that contained falsely recalled or extraneous information. Results Ninety-five physicians were randomized. Eighty-two physicians completed the experiment, for a response rate of 86%. The mean of the total number of themes recalled per participant was 3.1 in the narrative arm versus 2.0 in the summary arm (difference = 1.1, 95% confidence interval [CI] = 0.6 to 1.7). For three themes, the proportion of responses that recalled the theme was significantly greater in the narrative arm compared to the summary arm, with the differences ranging from 20% to 51%. For one theme, recall was significantly greater in the summary arm. For two themes, there was no statistically significant difference in recall between the arms. In the summary arm, 54% of responses were found to contain falsely recalled or extraneous information versus 21% of responses in the narrative arm (difference = 33%, 95% CI = 14% to 53%). Conclusions Physicians exposed to a narrative about opioid guidelines were more likely to recall guideline content at 1 hour than those exposed to a summary of the guidelines. Future studies should examine whether the incorporation of narratives in dissemination campaigns improves guideline adoption and changes clinical practice.

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Randomized Trial of Web-based Training About Opioid Therapy for Chronic Pain

Abstract: Exposure to an interactive web-based training focused on shared decision-making and communication skills was more effective than exposure to compatible practice guidelines for knowledge and self-reported competence in the management of chronic noncancer pain.

Cited by 49 publications

References 20 publications

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

Contrasting Tensions Between Patients and PCPs in Chronic Pain Management: A Qualitative Study: Table 1

Evidence‐based Narratives to Improve Recall of Opioid Prescribing Guidelines: A Randomized Experiment

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