Open AccessBRIEF REPORT: Training Internists in Shared Decision Making About Chronic Opioid Treatment for NonCancer Pain
Author(s) -
Sullivan Mark D.,
Leigh Janis,
Gaster Barak
Publication year - 2006
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2006.00352.x
Subject(s) - medicine , chronic pain , randomized controlled trial , intervention (counseling) , patient satisfaction , opioid , methadone , physical therapy , family medicine , primary care physician , primary care , nursing , psychiatry , receptor
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.