Changing residents' beliefs and concerns about treating chronic noncancer pain with opioids: evaluation of a pilot workshop.

OBJECTIVE

To determine if a pilot phase workshop influenced residents' beliefs and concerns about using opioids for chronic noncancer pain.

DESIGN

Pre- and post-survey questionnaire.

SETTING

University residency program.

PARTICIPANTS

Seventy-two Medicine and Medicine-Pediatrics residents.

INTERVENTIONS: Participation in a 4-hour workshop based on adult learning theory.

OUTCOME MEASURES: Residents' pre- and post-workshop concerns, feelings, and beliefs about the efficacy and safety of opioids for chronic noncancer pain (low back pain), and barriers to prescribing them (paired t-tests).

RESULTS

On a scale of 1 = least to 10 = most, residents' concerns about addiction risk from opioids in patients with chronic noncancer pain dropped significantly (P < 0.001) after the workshop (Pre 6.02 to Post 3.07). Similar changes were observed regarding concerns about abuse (5.61 to 3.92), side effects (4.88 to 2.88), limiting use of other treatments (5.41 to 3.60), sanctioning (State Board; 4.27 to 3.71; Legal 4.22 to 3.43), and drawing criticism from attending staff (4.50 to 2.77), with P < 0.001 for each. Their beliefs about efficacy and safety of opioids for chronic noncancer pain increased (Pre 4.96 to Post 7.40), and they were more comfortable prescribing them (4.30 to 6.82), with P < 0.001 for both. After the workshop, nine of 13 barriers to prescribing opioids for chronic noncancer pain were significantly (P < 0.05) lower.

CONCLUSION

Residents' beliefs and concerns about using opioids for chronic noncancer pain changed after participating in a 4-hour interactive workshop.