Brief report: Training internists in shared decision making about chronic opioid treatment for noncancer pain.

Full Abstract

BACKGROUND:
The use of chronic opioids for noncancer pain is an increasingly common and difficult problem in primary care.

OBJECTIVE:
To test the effects on physicians' self-reported attitudes and behavior of a shared decision-making training for opioid treatment of chronic pain.

DESIGN:
Randomized-controlled trial.

PARTICIPANTS:
Internal Medicine residents (n=38) and attendings (n=7) were randomized to receive two 1-hour training sessions on a shared decision-making model for opioid treatment for chronic pain (intervention, n=22) or written educational materials (control, n=23).

MEASUREMENTS:
Questionnaires assessing physician satisfaction, physician patient-centeredness, opioid prescribing practices, and completion rates of patient treatment agreements administered 2 months before and 3 months after training.

RESULTS:
At follow-up, the intervention group reported significantly greater overall physician satisfaction (P=.002), including subscales on relationship quality (P=.03) and appropriate use of time (P=.02), self-reported completion rates of patient treatment agreements (P=.01), self-reported rates of methadone prescribing (P=.05), and self-reported change in care of patients with chronic pain (P=.01).

CONCLUSIONS:
Training primary care physicians in the shared decision-making model improves physician satisfaction in caring for patients with chronic pain and promotes the use of patient treatment agreements. Further research is necessary to determine whether this training improves patient satisfaction and outcomes.

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Author information

Author/s: Sullivan, Mark D (MD); Leigh, Janis (J); Gaster, Barak (B);

Affiliation: Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA. sullimar(-atsign-)u.washington.edu

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine (J Gen Intern Med), published in United States. (Language: eng)

Reference: 2006-Apr; vol 21 (issue 4) : pp 360-2

Dates: Created 2006/05/11; Completed 2006/08/01; Revised 2008/11/20;

PMID: 16686813, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: J Gen Intern Med. 2006 Oct;21(10):1128-9; author reply 1129. (PMID: 16970564)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Analgesics, Opioid - administration & dosage; therapeutic use
Attitude of Health Personnel
Chronic Disease
Decision Making
Humans
Internal Medicine - education
Methadone - therapeutic use

Associated Chemicals: Analgesics, Opioid (0) ; Methadone (76-99-3)

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