Date: Sunday, November 5, 2017
Session Title: ARHP Clinical Practice/Patient Care/Health Services Research
Session Type: ARHP Concurrent Abstract Session
Session Time: 4:30PM-6:00PM
Background/Purpose: 1) To evaluate providers’ experience and knowledge with chronic pain management and opioid use with actual utilization of the Centers for Disease Control’s 2016 Guidelines for Prescribing Opioids for Chronic Pain. 2) To evaluate the specific influence of continuing education (CME), familiarity with CDC guidelines, and provider profession and region on confidence and best practice adherence in chronic pain management.
A cross-sectional, web-based survey conducted between January and April of 2017 with a convenience sample of 417 Oregon prescribing providers consisting of 210 MD and 207 NP participants (Urban/Rural= 64/36%; Age= 49.7 sd=12.2, Female=32%, Years of Practice= 15.7, sd =12.3). Measures included CME hours in past 2 years (minimal, 0-3; moderate, 4-10; high, 11 or more) and CDC familiarity (not read or read not applied vs. read and applied). Primary outcome variables included provider confidence in pain management (0-9), opioid conversion confidence (0-9), and adherence to best practices (opioid risk tool, urine drug screening, opioid treatment agreement, Oregon Prescription Drug Monitoring Program; all Likert, 0-5). Multivariate analysis of variance (MANOVA) and Chi-Square were used to analyze the influence of CME, CDC familiarity, provider profession and regional medical setting on provider best practices and confidence ratings.
Results: CME hours was significantly associated with increased use of opioid best practices (2.6, 3.2, 3.8; p <.001; scale 0-5), opioid conversion confidence (5.5, 6.5, 7.4; p. <.001; scale 0-9) and confidence in pain management (5.5, 5.9, 6.9; p <.001, scale 0-9). Providers familiar with CDC guidelines were only slightly more likely to apply best practices than were not (57% vs 43%), while increases in CME were more strongly associated with CDC best practices use (42% vs 57% vs 72%; p <.001). Neither providers professional status (MD vs NP) nor regional setting (urban vs. rural) showed differences in opioid best practices or general confidence in pain management with the exception of opioid conversion confidence where NPs reported slightly less than MDs (5.9 vs. 6.9; p <. 001, scale 0-9) and rural slightly more than urban providers (6.8 vs 6.2; p<. 05; scale 0-9).
Conclusion: Results demonstrate that recent CME in chronic non-cancer pain positively benefits provider confidence in pain management and application of best practices, as defined by the CDC guidelines. Nurse Practitioners and rural providers were found to provide equivalent adherence to best practices and confidence levels to their MD and urban counterparts, with minor exceptions.
To cite this abstract in AMA style:Jones K, Friend R, M. Bennett R, McCalmont J. Do Familiarity with Centers for Disease Control Guidelines, Continuing Education, and Provider Characteristics Influence Adherence to Chronic Pain Management Practices and Opioid Prescribing? [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/do-familiarity-with-centers-for-disease-control-guidelines-continuing-education-and-provider-characteristics-influence-adherence-to-chronic-pain-management-practices-and-opioid/. Accessed April 9, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/do-familiarity-with-centers-for-disease-control-guidelines-continuing-education-and-provider-characteristics-influence-adherence-to-chronic-pain-management-practices-and-opioid/