Quality improvement initiative for pain management in primary care

In the context of both chronic pain and opioid crises, this large-system quality improvement project sought to increase use of evidence-based multimodal pain management strategies.  Primary care providers (PCPs) in internal medicine and family medicine identified as above- median prescribers of 30-day opioid supplies were selected for intervention.  PCPs received individualized email letters showing their opioid prescribing patters relative to peers and urging them to view an internal pain/opioid educational video and related system guidelines.  The median number of patients receiving 30-day opioid supplies from our target PCPs decreased over a 24-month period.  For cohort patients identified as baseline and remaining in treatment over time, those receiving opioid prescriptions decreased, and those receiving nonopioid prescriptions increased.  Percentages of PCPs prescribing nonopioids for cohort patients increased over the first year and nonpharmacologic referrals increased in range.  Our evidence suggests that PCPs who are higher opioid prescribers will change their practices voluntarily when given feedback about their opioid prescribing patterns relative to their peers, as well as education regarding evidence-based pain management and opioid prescribing.

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    Faculty credentials/disclosure

    Dr. Embry is the E. Rhodes and Leona B. Carpenter Foundation Chair in Family Medicine, co-chair of the Baylor Scott & White Pain Management and Opioid Prescribing Ambulatory Taskforce, and clinical assistant professor at Texas A&M Health Science Center. Dr. Reis is senior vice president and chief medical officer of the Temple Regional Clinics, medical director of family medicine, and co-chair of the Baylor Scott & White Pain Management and Opioid Prescribing Ambulatory Taskforce. Dr. Couchman is senior vice president and chief medical officer, clinical operations, and executive sponsor of the Baylor Scott & White Pain Management and Opioid Prescribing Ambulatory Taskforce. Dr. Ledbetter is senior vice president and chief medical officer of the Dallas–Fort Worth Central Region and vice chairman of the Baylor Scott & White Quality Alliance Board of Managers. Mr. Zolfaghari is a biostatistician for the Center for Applied Health Research, Baylor Scott & White Health. The authors and planner have no conflicts of interest to disclose.

    Process

    Click the take course button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit.  You must achieve 100% on the quiz with unlimited attempts available.

    • By completing this process, you are attesting that you have read the journal article.
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    For more information about CME credit, or technical questions about obtaining CME credit, please email ce@bswhealth.org

    Expiration date

    Credit eligibility for this article is set to expire on October 1, 2022.

    Target Audience

    All physicians and healthcare providers

    Learning Objectives

    After completing the article, the learner should be able to:

    1.  Assess chronic pain clinical practice in relation to current evidence-based guidelines

    2.  Integrate additional chronic pain education their own practices

    Course summary
    Available credit: 
    • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2 Medical Knowledge
      Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Medical Knowledge points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
    • 1.00 AMA PRA Category 1 Credit™
      The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
      • 1.00 Ethics
    • 1.00 Attendance
      • 1.00 Ethics
    Course opens: 
    10/01/2020
    Course expires: 
    10/01/2022
    Cost:
    $25.00
    Rating: 
    0

    Accreditation 

    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Designation

    AMA PRA Category 1 Credit

    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Available Credit

    • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2 Medical Knowledge
      Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Medical Knowledge points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
    • 1.00 AMA PRA Category 1 Credit™
      The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
      • 1.00 Ethics
    • 1.00 Attendance
      • 1.00 Ethics

    Price

    Cost:
    $25.00
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