Training Needs of Practice Facilitators When Implementing An Opioid Improvement Initiative in Primary Care

Abstract

Background: Practice facilitation is a commonly employed strategy to implement evidence-based programs into primary care settings. Preparing facilitators for this role requires an understanding of their training needs and support. Here we report on the experiences of facilitators who participated in a training program to support efforts to improve opioid medication management in primary care.Methods: Trainees with prior QI experience were recruited for the six-month training program. Each trainee recruited a clinic for which they would serve as an external facilitator to implement the Six Building Blocks program. At the end of the six-months, we conducted two semi-structured interviews with each trainee. The interviews focused on facilitators and barriers that the trainees experienced during the training and support provided. Qualitative content analysis was used to analyze the transcribed interviews.Results: Three of the five trainees completed the program. In addition to the in-depth understanding of the Six BB program, trainees valued the opportunity to build peer relationships which provided a supportive peer support group. They valued the availability of more experienced facilitators who supported and mentored them. They also mentioned the importance of providing helpful tools and resources and the availability of a clinical expert. Barriers focused on factors internal to the trainees’ clinical setting, the trainees limited clinical knowledge about chronic pain, and difficulty maintaining momentum for change due to the flexible timeline of the program itself.Conclusions: In addition to training on the content of an evidence-based programs, facilitators valued work with supportive peers and the mentoring of more experienced facilitators. Primary care improvement initiatives employing practice facilitators should consider these training needs and the resources required for this supportive infrastructure.

STRategies to Improve Pain and Enjoy life (STRIPE): results of a pragmatic randomized trial of pain coping skills training and opioid medication taper guidance for patients on long-term opioid therapy

“…1,15,32 In addition, abrupt opioid cessation, compared with gradual opioid tapering, is associated with lower likelihood of sustaining opioid discontinuation. 33 Greater knowledge is needed regarding patient-centered strategies to reduce doses among patients on moderate-to-high dose of LtOT without harm and the impact of dose tapering on pain and related outcomes.…”

“…Secondary outcomes: adjusted means and adjusted mean differences between randomized groups at 6 and 12 mo. ) 33. In our study sample, almost three-quarters of our participants previously attempted to taper their opioids.…”