Army and Navy ECHO Pain Telementoring Improves Clinician Opioid Prescribing for Military Patients: an Observational Cohort Study

Autor: Clifford Qualls, Robin Swift, Martin Kistin, George Comerci, William A. Satterfield, Sanjeev Arora, Rebecca Fowler, Keith Hofmann, Joanna G. Katzman, Nina Greenberg
Rok vydání: 2018
Předmět:
Zdroj: Journal of General Internal Medicine. 34:387-395
ISSN: 1525-1497
0884-8734
Popis: Opioid overdose deaths occur in civilian and military populations and are the leading cause of accidental death in the USA. To determine whether ECHO Pain telementoring regarding best practices in pain management and safe opioid prescribing yielded significant declines in opioid prescribing. A 4-year observational cohort study at military medical treatment facilities worldwide. Patients included 54.6% females and 46.4% males whose primary care clinicians (PCCs) opted to participate in ECHO Pain; the comparison group included 39.9% females and 60.1% males whose PCCs opted not to participate in ECHO Pain. PCCs attended 2-h weekly Chronic Pain and Opioid Management TeleECHO Clinic (ECHO Pain), which included pain and addiction didactics, case-based learning, and evidence-based recommendations. ECHO Pain sessions were offered 46 weeks per year. Attendance ranged from 1 to 3 sessions (47.7%), 4–19 (32.1%, or > 20 (20.2%). This study assessed whether clinician participation in Army and Navy Chronic Pain and Opioid Management TeleECHO Clinic (ECHO Pain) resulted in decreased prescription rates of opioid analgesics and co-prescribing of opioids and benzodiazepines. Measures included opioid prescriptions, morphine milligram equivalents (MME), and days of opioid and benzodiazepine co-prescribing per patient per year. PCCs participating in ECHO Pain had greater percent declines than the comparison group in (a) annual opioid prescriptions per patient (− 23% vs. − 9%, P
Databáze: OpenAIRE
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