Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physicians
Objectives Opioid-related deaths continue to increase in North America, an epidemic that was initiated by high rates of opioid prescribing. We designed a multifaceted, theory-informed Opioid Self-Assessment (OSA) package, to increase adherence to the Canadian Opioid Guideline among family physicians...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/1/e032167.full |
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| author | Andrea D Furlan Michael Hamilton Meldon Kahan Pamela Leece Navindra Persaud Yalnee Shantharam Samah Hassam Daniel Z Buchman Sheryl Spithoff Anita Srivastava Beth A Sproule Leslie Carlin |
| author_facet | Andrea D Furlan Michael Hamilton Meldon Kahan Pamela Leece Navindra Persaud Yalnee Shantharam Samah Hassam Daniel Z Buchman Sheryl Spithoff Anita Srivastava Beth A Sproule Leslie Carlin |
| author_sort | Andrea D Furlan |
| collection | DOAJ |
| description | Objectives Opioid-related deaths continue to increase in North America, an epidemic that was initiated by high rates of opioid prescribing. We designed a multifaceted, theory-informed Opioid Self-Assessment (OSA) package, to increase adherence to the Canadian Opioid Guideline among family physicians. This study aimed to assess changes in Canadian family physicians’ knowledge and practices after completing the OSA package.Design We conducted a mixed-method evaluation using a pre-test and post-test design that involved the collection of both qualitative and quantitative data.Setting This research was conducted in the primary care setting in Ontario, Canada.Participants We recruited a purposive sample of nine family physicians in Ontario who use long-term opioid therapy to treat patients with chronic pain.Interventions The OSA package included four components: an online knowledge test, an online learning programme, a safe medication practice self-assessment questionnaire and chart audit with feedback.Outcome measures Our measures included changes in knowledge, opioid safety practices and physicians’ perspectives on the OSA package.Results We found statistically significant improvements between pre-test and post-test knowledge scores at both baseline and 6-month follow-up. Physicians’ scores improved significantly on five of the seven core characteristics of the practice self-assessment questionnaire. On the chart audits, we observed an improvement in patient education between baseline and 6 months. Qualitative interviews showed that participants appreciated embedded resources in the OSA package. The completion of the package stimulated identification of gaps or deficits in practice and served as a useful reminder to discuss risk and safety with patients. Participants described the chart review as helpful in prompting discussions with their patients, identifying deficits and strengths and a ‘primary motivator’ for project participation.Conclusions The OSA package has the potential to improve medication safety practices in primary care related to opioid monitoring and adherence to current opioid guidelines. |
| format | Article |
| id | doaj-art-38ea5df7e56743218c0da3ca2e15456b |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-38ea5df7e56743218c0da3ca2e15456b2025-08-20T02:31:27ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-032167Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physiciansAndrea D Furlan0Michael Hamilton1Meldon Kahan2Pamela Leece3Navindra Persaud4Yalnee Shantharam5Samah Hassam6Daniel Z Buchman7Sheryl Spithoff8Anita Srivastava9Beth A Sproule10Leslie Carlin11Toronto Rehabilitation Institute, Toronto, Ontario, CanadaInstitute for Safe Medication Practices, Toronto, Ontario, CanadaWomen`s College Hospital, Toronto, Ontario, CanadaPublic Health Ontario, Toronto, Ontario, Canada1 Department of Family and Community Medicine, St Michael`s Hospital, Toronto, Ontario, CanadaToronto Rehabilitation Institute, Toronto, Ontario, CanadaToronto Rehabilitation Institute, Toronto, Ontario, CanadaDalla Lana School of Public Health, and Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, CanadaWomen`s College Hospital, Toronto, Ontario, CanadaDepartment of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, CanadaLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, CanadaDepartment of Physical Therapy, University of Toronto Faculty of Medicine, Toronto, Ontario, CanadaObjectives Opioid-related deaths continue to increase in North America, an epidemic that was initiated by high rates of opioid prescribing. We designed a multifaceted, theory-informed Opioid Self-Assessment (OSA) package, to increase adherence to the Canadian Opioid Guideline among family physicians. This study aimed to assess changes in Canadian family physicians’ knowledge and practices after completing the OSA package.Design We conducted a mixed-method evaluation using a pre-test and post-test design that involved the collection of both qualitative and quantitative data.Setting This research was conducted in the primary care setting in Ontario, Canada.Participants We recruited a purposive sample of nine family physicians in Ontario who use long-term opioid therapy to treat patients with chronic pain.Interventions The OSA package included four components: an online knowledge test, an online learning programme, a safe medication practice self-assessment questionnaire and chart audit with feedback.Outcome measures Our measures included changes in knowledge, opioid safety practices and physicians’ perspectives on the OSA package.Results We found statistically significant improvements between pre-test and post-test knowledge scores at both baseline and 6-month follow-up. Physicians’ scores improved significantly on five of the seven core characteristics of the practice self-assessment questionnaire. On the chart audits, we observed an improvement in patient education between baseline and 6 months. Qualitative interviews showed that participants appreciated embedded resources in the OSA package. The completion of the package stimulated identification of gaps or deficits in practice and served as a useful reminder to discuss risk and safety with patients. Participants described the chart review as helpful in prompting discussions with their patients, identifying deficits and strengths and a ‘primary motivator’ for project participation.Conclusions The OSA package has the potential to improve medication safety practices in primary care related to opioid monitoring and adherence to current opioid guidelines.https://bmjopen.bmj.com/content/10/1/e032167.full |
| spellingShingle | Andrea D Furlan Michael Hamilton Meldon Kahan Pamela Leece Navindra Persaud Yalnee Shantharam Samah Hassam Daniel Z Buchman Sheryl Spithoff Anita Srivastava Beth A Sproule Leslie Carlin Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physicians BMJ Open |
| title | Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physicians |
| title_full | Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physicians |
| title_fullStr | Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physicians |
| title_full_unstemmed | Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physicians |
| title_short | Improving opioid guideline adherence: evaluation of a multifaceted, theory-informed pilot intervention for family physicians |
| title_sort | improving opioid guideline adherence evaluation of a multifaceted theory informed pilot intervention for family physicians |
| url | https://bmjopen.bmj.com/content/10/1/e032167.full |
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