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Knowledge and implementation of current opioid guidelines among healthcare providers in Manitoba

Diana C. Sanchez-Ramirez, PhD, MPH, PT, Christine Polimeni, MD


Objective: To explore self-perceived knowledge and implementation of current opioid guidelines among healthcare providers, and to assess the effect of an opioid-related educational intervention.

Design: Pre-post.

Setting: Academic.

Participants: Sixty-nine participants completed the pre-intervention survey, 45 percent of them also completed a post-survey.

Intervention: A short presentation on current opioid guidelines incorporated in a larger accredited continuing professional development (CPD) event.

Outcomes: The 5-point Likert scale to express their level of agreement with seven statements was used to estimate their knowledge and implementation of current opioids guideline, along with their self-perceived abilities and level of comfort in prescribing opioids (Moore's conceptual framework).

Results: Fifty percent of the participants were familiar with current opioid prescribing protocols and 46 percent were implementing them, 62 percent stated that were able to identify drug seeking behaviors in patients, 82 percent knew patients’ risk factors and 78 percent evaluated them before prescribing opioids, 90 percent indicated that they prescribed non-opioid alternatives, and 35 percent expressed that they feel comfortable prescribing opioids. Self-reported levels of familiarity with the current opioid prescribing protocols (p < 0.001) and knowledge of patients’ risk factors for prescribing opioids (p = 0.012) increased after the intervention. Improvements in their ability to identify drug seeking behavior in patients (p = 0.033), and in their comfort prescribing opioids for chronic non-cancer patients (p = 0.015) were also reported.

Conclusions: Healthcare providers’ knowledge and implementation of current opioids guidelines need to be strengthened. A single presentation on the opioid crisis and guidelines incorporated within a larger CPD event showed significant gains in self-reported knowledge and skills among healthcare providers.


Canada, opioid guidelines, education, healthcare providers

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Centers for Disease Control and Prevention: Opioid data analysis. 2016. Available at Accessed October 5, 2018.

Canadian Institute for Health Information: Opioid-Related Harms in Canada. Ottawa, ON: Canadian Institute for Health Information, 2017. Available at Accessed April 18, 2018.

Special Advisory Committee on the Epidemic of Opioid Overdoses: National report: Apparent opioid-related deaths in Canada (January 2016 to June 2017). Ottawa, ON: Public Health Agency of Canada, 2017. Available at Accessed April 18, 2018.

Canada Institute for Health Information: Pan-Canadian trends in the prescribing of opioids, 2012 to 2016. Ottawa, ON: CIHI, 2017. Available at Accessed April 18, 2018.

Sproule B, Brands B, Li S, et al.: Changing patterns in opioid addiction: Characterizing users of oxycodone and other opioids. Can Fam Physician. 2009; 55(1): 68-69.

Busse JW, Craigie S, Juurlink DN, et al.: Guideline for opioid therapy and chronic noncancer pain. CMAJ. 2017; 189(18): E659-E666.

The College of Family Physicians of Canada: Chronic pain and opioid resources. Available at Accessed October 5, 2018.

Forsetlund L, Bjorndal A, Rashidian A, et al.: Continuing education meetings and workshops: Effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2009; (2): CD003030.

Moore DE Jr, Green JS, Gallis HA: Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. J Contin Educ Health Prof. 2009; 29(1): 1-15.

Kirkpatrick D, Kirkpatrick J: Evaluating Training Programs: The Four Levels. San Francisco, CA: Berrett-Koehler Publishers Inc., 2006.

Wenghofer EF, Wilson L, Kahan M, et al.: Survey of Ontario primary care physicians’ experiences with opioid prescribing. Can Fam Physician. 2011; 57(3): 324-332.

National Pain Centre: The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain. Hamilton, ON: McMaster, 2017. Available at Accessed April 18, 2018.

Pretorius RW, Zurick GM: A systematic approach to identifying drug-seeking patients. Fam Pract Manag. 2008; 15(4): A3-A5.

Roland D: Proposal of a linear rather than hierarchical evaluation of educational initiatives: The 7Is framework. J Educ Eval Health Prof. 2015; 12: 35.



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