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(117) Implementing Shared Decision Making Training for Clinicians Prescribing Opioids to Chronic Noncancer Pain Patients


Authors:

Lauren A. McCormack, PhD, MPH – Division Vice President, Public Health Research, RTI International

Abstract:

Session/Poster Description: Up to one-third of Americans suffer from chronic noncancer pain (CNCP) and are treated primarily with pharmacologic approaches. The evidence supporting the effective long-term use of opioids is limited, and the field has recognized the need to change the conversation about opioids for managing chronic pain. Supporting both patients and clinicians by providing information, education and training to engage in Shared Decision Making (SDM) is one approach to promoting more evidence-based decisions. We tailored an existing, evidence-based SDM program for clinicians who treat patients with CNCP. We trained all clinicians participating in a PCORI-funded large, pragmatic trial to use the SDM approach. The trial is comparing the effectiveness of SDM versus motivational interviewing/cognitive behavioral therapy for patients currently receiving moderate-to-high dose opioids in three academic medical centers. The SDM curriculum provides Continuing Medical Education (CME) credit and includes a patient-facing decision aid packet. The training can be easily implemented and scaled up to promote sustainability.
SDM is an essential component of patient-centered health care that seeks to promote informed decision-making considering benefits, risks, and uncertainties related to the evidence. While SDM principles have been well documented, clear guidance is lacking about how to implement it in routine clinical practice. We will present our experiences and lessons learned implementing the program from both the patient and clinician perspective. Our focus will be on real-world challenges and success stories with chronic pain patients and insights about best practices for promoting the uptake of evidence-based interventions.

Contributors: Rowena Dolor, MD, MHS; Lynn Bowlby, MD; Jenna Walters, MD

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