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Online training of primary care providers in pain and addiction

      The majority of primary care providers in the pain practice community have not fully incorporated evidence-based and clinical consensus recommendations for preventing, recognizing, and managing addiction in pain patients. Existing interventions based on conferring knowledge or providing prompts are limited in effect. With support from NIDA, we are designing an online training experience for pain management providers that focuses on skills training. We surveyed addiction specialists (n = 9) to better understand the needs and limitations of primary care providers. All addiction specialists identified a need for additional training in: 1) Detecting Substance Use Disorders in Pain Patients at Initial Evaluation, 2) Preventing Substance Use Disorders When Prescribing Opioids to Pain Patients, 3) Managing Addiction Issues in Ongoing Treatment of Chronic Pain Patients, and 4) Preventing and Detecting Diversion of Pain Medications [listed in the respondents' order of priority]. When asked about supplementary disease focused training in addiction issues, they highlighted back pain as the top priority followed by headache, osteoarthritis, and fibromyalgia/neuropathy [tied]. All addiction expert participants expressed interest in participating in features such as an online forum and an “Ask the Expert” forum. A survey of pain specialists (n = 5) ranked the four topics similarly and also identified back pain as the most important topic. A survey of primary care physicians (n = 9) revealed that all would consider taking a course with an Standardized Patient component; the most preferred modality was online chat. Most preferred a short SP experience that would more closely mimic the clinic encounter. With expert and target audience input, we have outlined a skills training experience based on the topics above and which uses virtual (i.e., Internet chat-based) Standardized Patients as well as interactive clinical cases with multiple questions. (This research is funded by NIDA/NIH contract #HHSN271200800012C.)
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