Tuesday, November 17, 2015

Misprescribing Controlled Substances: An Evaluation of a Professional Development Program

BACKGROUND:
Controlled Prescription Drug (CPD) abuse has reached epidemic proportions in the United Sates. Most physicians attending a three-day continuing medical education (CME) professional development program (PDP) lack training in identifying risk and in managing patients who misuse CPDs. To address this issue, the authors conducted an evaluation of a professional development program (PDP) that trains physicians on proper prescribing, identifying substance abuse, Screening, Brief Interventions and Referral to Treatment (SBIRT), and Motivational Interviewing (MI).

METHODS:
The authors conducted a program evaluation to assess the efficacy and impact of the course on physicians' knowledge and prescribing behaviors.

RESULTS:
Participants (N=174) were typically middle aged (average age of 53 years), male (89%), physicians (82%) and other healthcare providers (18%) practicing in primary care solo practices. 

Course evaluations were completed by N=155 (89%) participants who rated the course and presenters highly (mean 4.8/5 for each). Physicians' knowledge scores on pre/post assessments increased significantly; pre-test (M= 58.7, SD = 13.12) and post-test (M = 78.28, SD = 9.83), (t (173) = 20.06, p ≤ .0001, 95% CI [-21.51, -17.65]). 

Almost half of the participants N=83/174 (48%) completed the follow-up survey and 93% agreed/strongly agreed (A/SA) they made professional practice changes. Of those practicing with prescribing privileges (N=57), the following agreed/strongly agreed to the following: implemented changes to align practices with current guidelines (89%), used CPD more appropriately (87%) and implemented office policies on prescribing (81%), identified and referred more substance abuse patients to treatment (80%), shared new information/experience from course with other health professionals (93%) and felt the course positively impacted their behaviors personally and professionally (90% and 96% respectively).

CONCLUSIONS:
This is the first study evaluating a PDP of this type. Results demonstrated participant satisfaction and improvement in prescribers' knowledge and self-reported prescribing behaviors. However, further study is needed to assess actual clinical practice changes, direct impact on patient outcomes and rates of recidivism.

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  • 1 Vanderbilt University School of Medicine , Nashville , TN , USA. 




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