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Knowledge gaps and practice patterns of clinicians treating patients with opioid use disorder

Maziar Rasulnia, PhD, Billy Stephen Burton, MS, Dhiren Patel, PharmD

Abstract


Objective: The goal of the study was to assess knowledge gaps and practice patterns of US-based addiction specialists, primary care physicians (PCPs), nurse practitioners (NPs), and physician assistants (PAs) who treat patients with opioid use disorder (OUD).

Design: As part of a prospective study, the authors developed a survey tool consisting of case-vignettes and questions designed to reveal practice patterns and highlight gaps in clinician knowledge.

Setting: The primary study setting included clinicians practicing in outpatient care.

Participants: The surveys were distributed via email between August and September 2017 to a national sample of addiction specialists, PCPs, and NPs/Pas that see at least one patient per week and at least 1 percent of their patient population had to be diagnosed with OUD.

Results: The knowledge assessment results varied among the clinicians surveyed. Addiction specialists saw more patients with OUD than PCPs, NPs, or PAs. They also demonstrated a higher level of understanding and knowledge of the various domains assessed.

Conclusions: There are multiple educational intervention strategies that can support the clinicians; including reducing restrictions to access treatment for OUD, care coordination programs for patients to improve early access to treatment and education, and frequent chart audit and feedback programs to support clinician decision making and education.


Keywords


opioid use disorder, provider knowledge, provider practices, continuing medical education, provider education

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References


Hedegaard H, Warner M, Miniño AM: Drug Overdose Deaths in the United States, 1999–2016. NCHS Data Brief, No. 294. Hyattsville, MD: National Center for Health Statistics, 2017.

Rudd RA, Seth P, David F, et al.: Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016; 65(5051): 1445-1452. doi:10.15585/mmwr.mm655051e1.

The Executive Office of the President of the United States: The underestimated cost of the opioid crisis. 2017. Available at https://www.whitehouse.gov/sites/whitehouse.gov/files/images/The%20Underestimated%20Cost%20of%20the%20Opioid%20Crisis.pdf. Accessed February 15, 2018.

Office of the Surgeon General: Facing addiction in America: The Surgeon General's report on alcohol, drugs and health. Available at https://addiction.surgeongeneral.gov/sites/default/files/surgeon-generals-report.pdf. Accessed February 15, 2018.

Laverdiere D, Silva J, Pereyda M, et al.: Changing Course: The Role of Health Plans in Curbing the Opioid Epidemic. Oakland, CA: California Health Care Foundation, 2016. Available at https://www.chcf.org/wp-content/uploads/2017/12/PDFChangingHealthPlansOpioid.pdf. Accessed February 15, 2018.

Pearson A, Moman R, Moeschler S, et al.: Provider confidence in opioid prescribing and chronic pain management: Results of the opioid therapy provider survey. J Pain Res. 2017; 10: 1395-1400. doi:10.2147/jpr.s136478.

Jones CM, Campopiano M, Baldwin G, et al.: National and state treatment need and capacity for opioid agonist medication- assisted treatment. Am J Public Health. 2015; 105(8): e55-e63. doi:10.2105/ajph.2015.302664.

Finnell JT, Twillman RK, Breslan SA, et al.: The role of continuing medical education in increasing enrollment in prescription drug monitoring programs. Clin Ther. 2017; 39(9): 1896-1902. e2. doi:10.1016/j.clinthera.2017.07.040.

Peabody JW, Luck J, Glassman P, et al.: Measuring the quality of physician practice by using clinical vignettes: A prospective validation study. Ann Intern Med. 2004; 141(10): 771-780.

Davis CS, Carr D: Physician continuing education to reduce opioid misuse, abuse, and overdose: Many opportunities, few requirements. Drug Alcohol Depend. 2016; 163: 100-107. doi:10.1016/j.drugalcdep.2016.04.002.

McClamont JC, Jones KD, Bennett RM, et al.: Does familiarity with CDC guidelines, continuing education, and provider characteristics influence adherence to chronic pain management practices and opioid prescribing? J Opioid Manage. 2018; 14 (2): 103-116. Available at http://www.wmpllc.org/ojs-2.4.2/index.php/jom/article/view/1531. Accessed September 2, 2018. doi:10.5055/jom.2018.0437.

Levin FR, Bisaga A, Sullivan MA, et al.: A review of a national training initiative to increase provider use of MAT to address the opioid epidemic. Am J Addict. 2016; 25(8): 603-609. doi:10.1111/ajad.12454.

Purcell N, Zamora K, Tighe J, et al.: The integrated pain team: A mixed-methods evaluation of the impact of an embedded interdisciplinary pain care intervention on primary care team satisfaction, confidence, and perceptions of care effectiveness. Pain Med. 2018; 19(9): 1748-1763. doi:10.1093/pm/pnx254.




DOI: https://doi.org/10.5055/jom.2019.0536

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