The authors have no conflicts of interest to report.
BRIEF REPORT: Training Internists in Shared Decision Making About Chronic Opioid Treatment for NonCancer Pain
Article first published online: 12 APR 2006
Journal of General Internal Medicine
Volume 21, Issue 4, pages 360–362, April 2006
How to Cite
Sullivan, M. D., Leigh, J. and Gaster, B. (2006), BRIEF REPORT: Training Internists in Shared Decision Making About Chronic Opioid Treatment for NonCancer Pain. Journal of General Internal Medicine, 21: 360–362. doi: 10.1111/j.1525-1497.2006.00352.x
- Issue published online: 3 MAY 2006
- Article first published online: 12 APR 2006
- Manuscript received August 2, 2005Initial editorial decision September 22, 2005Final acceptance November 10, 2005
- chronic pain;
- randomized trial;
- physician satisfaction;
- opioid contracts
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.