Teaching Opioid Tapering Through Guided Instruction
| Autor: | Courtenay Gilmore Wilson, Carriedelle Wilson Fusco, Shelley L. Galvin, Rebecca Claire Austin, E. Blake Fagan, Josh Pacious, Hallum Dickens, Evan S. Drake |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Concordance MEDLINE 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Chart review Medicine Humans Pain Management Practice Patterns Physicians' Aged Retrospective Studies 030203 arthritis & rheumatology Benzodiazepine business.industry Internship and Residency Retrospective cohort study Analgesics Opioid Opioid Concomitant Physical therapy Morphine Female Chronic Pain business Family Practice medicine.drug |
| Zdroj: | Family medicine. 51(5) |
| ISSN: | 1938-3800 |
| Popis: | Background and Objectives: Given the current opioid epidemic, national practice guidelines and many state laws are shifting the treatment paradigm for chronic, noncancer pain to a judicious use of opioids. This has prompted a need to teach family medicine residents how to appropriately taper opioids. We created a multifaceted approach to integrate teaching of opioid tapering into a family medicine curriculum with an emphasis on guided instruction. We assessed the degree to which this curriculum affected guideline-concordant opioid prescribing within the family medicine practice. Methods: A retrospective chart review of 707 patients on chronic opioid therapy (COT) for noncancer pain was conducted before and after the incorporation of a guided instruction experience to the residency curriculum. The primary outcomes included the number of patients on chronic opioids, the average morphine equivalent daily (MED) per patient, the percentage of patients on >50 MED or >90 MED, and the number of patients on concomitant benzodiazepines. Results: Of the original 707 patients, 188 tapered off COT. Of those remaining on COT, the average MED did not change (53.4±76.9 vs 58.5+89.1, P=0.053). The percentage of patients on >50 MED and >90 MED decreased significantly (30.6% vs 25.0%, P=0.001; 19.4% vs 14.0%, P=0.027). The total number of patients on concomitant benzodiazepine decreased from 212 to 131. Conclusions: Providing opportunities for guided instruction with opioid tapering allowed for an increased concordance with national practice guidelines. |
| Databáze: | OpenAIRE |
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