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Educational Outcomes: Outcomes Breaking New Reports

OC Blast on Chronic Pain

Physicians improved their understanding of the management of chronic pain with opioids and committed to maintaining a robust communication dynamic with their patient about their functional status

Physicians improved their understanding of the management of chronic pain with opioids and committed to maintaining a robust communication dynamic with their patient about their functional status
The outcomes performance measures for the Chair Summit 2013 Pain Track were to implement measurement-based tools at initial and follow-up visits to document and measure pain and functional capabilities over time in patients with chronic pain and further use these data to inform individualized care for patients with chronic pain. These measures trace to the Institute for Clinical Systems Improvement (ICSI) quality measure (ICSI Guideline, 5th edition, November 2011), involving "using a standardized tool that addresses pain intensity, location, pattern, mechanism of pain, current functional status, and follow-up plan."
A pre-activity survey at Chair Summit 2013 collected performance data from clinicians who affirmed that they manage patients with chronic pain. Results regarding clinicians' assessment of "functional status," as well as improving communication about pain, were as follows:
Baseline rates were suboptimal, where 43.3% of these clinicians were conversing with less than half of their patients with chronic pain about the effects of their pain on functional status (n = 37; see Figure).
After participating, 83.3% made strong commitments (ratings 4-5 of 5) to talking with their patients about the effects of their pain on functional status (n = 18).
After participating, 61.1% also made strong commitments (ratings 4-5 of 5) to routinely incorporating validated measurements of pain (n = 18).
Chair Summit participants also improved their applied understanding of pain management with opioids. The best answer in a case vignette was "opioid-induced hyperalgesia," and 50.0% of participants responded correctly at baseline (n = 36), with an increase to 88.9% in the immediate posttest (n = 18). The other options were "opioid tolerance and addiction" (changed from 50.0% to 5.6%) and "paradoxical opioid response" (changed from 0.0% to 5.6%).
Expert faculty, Constantine D. Sarantopoulos, MD, PhD, DEAA, emphasized during the live meeting that hyperalgesia is much more common and much more overlooked than clinicians believe, especially because hyperalgesia is a paradoxical reaction to a pain medicine. He also explained that there is an appropriate time and place for opioid treatment but that prescribers need to be alert to more than just addiction. Educating clinicians about hyperalgesia fills an unmet need to better understand the role of opioids in pain management.

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