MAP-PC: An Addiction Medicine Training Course for Primary Care Pain Treatment

MAP-PC：初级保健疼痛治疗成瘾医学培训课程

基本信息

批准号：
7668318
负责人：
Emil J. Chiauzzi
金额：
$ 24.78万
依托单位：
INFLEXXION, INC.
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-04-15 至 2010-03-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7668318
关键词：
Acute Pain Address Adopted Alcohol or Other Drugs use Analgesics Breakthrough Pain Caring Chronic Clinical Development Development Plans Diagnosis Drops Education Educational process of instructing Evaluation Exposure to Fright Goals Internet Knowledge Lead Learning Logic Malignant Neoplasms Medication Management Medicine Monitor Opioid Pain Pain Clinics Pain management Patients Pharmaceutical Preparations Phase Physicians Primary Care Physician Primary Health Care Provider Quality of Care Quality of life Recording of previous events Research Research Project Grants Risk Substance abuse problem Techniques Technology Testing Text Time Training Treatment outcome Update Voice addiction base behavior change brief intervention case-based chronic pain continuing medical education design experience flexibility high risk improved innovation new technology non-cancer pain opioid misuse overdose death programs public health relevance shared decision making skills tool virtual web site

项目摘要

DESCRIPTION (provided by applicant): This Fast Track proposes the development of an online Continuing Medical Education (CME) program for primary care physicians called Managing Addiction and Pain in Primary Care (MAP-PC). Multiple studies have confirmed the usefulness of opioids in the treatment of acute pain and pain related to cancer, but they continue to be under-prescribed by physicians. Many physicians are concerned about possible abuse by patients (e.g., diversion, drug-related overdoses, and death), potential liability, and censure by regulatory agencies. The reluctance to prescribe opioids is particularly evident among primary care physicians (PCPs), who treat a high proportion of pain patients. An improvement in the ability of primary care physicians to adopt addiction medicine principles would lead to more appropriate use of opioids, along with more successful pain treatment outcomes in patients, especially those with potential or past substance abuse. Unfortunately, there is a lack of addiction medicine training for physicians treating pain patients. Physicians receive limited exposure to such information during their training and current CME courses focus on opioid prescribing, diagnosis, and pain management issues rather than providing a comprehensive understanding of addiction medicine in the pain treatment context. In addition, the great majority of these courses are not tested, offer an experience that is simply text-based with limited or no interactivity, and are focused simply on knowledge change rather than behavior change. With the advent of the Internet, there is technology available to engage and educate physicians seeking to build addiction medicine skills. The goal of Managing Addiction and Pain in Primary Care (MAP-PC) is to help primary care physicians learn addiction medicine skills through an online, interactive, skill- building CME course for treating chronic non-cancer pain patients. Using virtual patient technology, MAP-PC will: (1) increase addiction medicine skills, e.g., identification, management, treatment, and referral for pain patients at risk of or evidencing addiction, (2) help physicians make informed decisions about the use of opioids for their patients, and (3) manage clinical challenges that arise during the course of pain treatment with opioids, e.g., breakthrough pain, acute pain, opioid misuse, and illicit substance use. PUBLIC HEALTH RELEVANCE: Pain is often under-treated primarily due to primary care physician's ambivalence to prescribing opioid medications for fear that the patient might abuse or become addicted to the medication. This is particularly true for patients with potential or past substance abuse. This research project will culminate in the development of an interactive Continuing Medical Education (CME) course that teaches primary care physicians ongoing pain management techniques, including the safe and responsible use of opioids. The course will place an emphasis on how to manage cases where the patient has a history of substance abuse, or is at high risk of becoming addicted.

描述（由申请人提供）：本快速通道建议为初级保健医生开发在线继续医学教育 (CME) 计划，称为初级保健中的成瘾和疼痛管理 (MAP-PC)。多项研究已证实阿片类药物在治疗急性疼痛和与癌症相关的疼痛方面的有效性，但医生仍然没有开具阿片类药物。许多医生担心患者可能存在滥用行为（例如转移、与药物相关的过量用药和死亡）、潜在的责任以及监管机构的谴责。初级保健医生（PCP）不愿意开阿片类药物的情况尤其明显，因为他们治疗的疼痛患者比例很高。初级保健医生采用成瘾医学原理的能力的提高将导致更适当地使用阿片类药物，并为患者（尤其是那些潜在或过去有药物滥用的患者）带来更成功的疼痛治疗结果。不幸的是，缺乏对治疗疼痛患者的医生的成瘾医学培训。医生在培训期间接触到的此类信息有限，目前的 CME 课程侧重于阿片类药物处方、诊断和疼痛管理问题，而不是提供对疼痛治疗背景下成瘾医学的全面了解。此外，这些课程中的绝大多数都没有经过测试，提供的体验只是基于文本，交互性有限或没有交互性，并且仅关注知识改变而不是行为改变。随着互联网的出现，有技术可以吸引和教育寻求建立成瘾医学技能的医生。初级保健中成瘾和疼痛管理 (MAP-PC) 的目标是帮助初级保健医生通过在线、互动、技能培养 CME 课程学习成瘾医学技能，以治疗慢性非癌症疼痛患者。使用虚拟患者技术，MAP-PC 将：(1) 提高成瘾医学技能，例如识别、管理、治疗和转诊有成瘾风险或有成瘾证据的疼痛患者，(2) 帮助医生就使用成瘾药物做出明智的决定为患者提供阿片类药物，(3) 管理阿片类药物疼痛治疗过程中出现的临床挑战，例如突发性疼痛、急性疼痛、阿片类药物滥用和非法物质使用。公共卫生相关性：疼痛常常得不到充分治疗，主要是由于初级保健医生对开阿片类药物的态度矛盾，担心患者可能滥用药物或对药物上瘾。对于潜在或过去滥用药物的患者尤其如此。该研究项目最终将开发交互式继续医学教育（CME）课程，向初级保健医生传授持续的疼痛管理技术，包括安全和负责任地使用阿片类药物。该课程将重点介绍如何处理患者有药物滥用史或成瘾风险较高的病例。