Improving Medical Student Knowledge and Reducing Stigmatizing Attitudes Toward Treating Patients With Opioid Use Disorder.

Substance use : research and treatment Pub Date : 2024-02-29 eCollection Date: 2024-01-01 DOI:10.1177/11782218241234808
Dana H Chung, Stephanie Slat, Aditi Rao, Jennifer Thomas, Adrianne Kehne, Colin Macleod, Erin F Madden, Pooja Lagisetty
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Abstract

Objectives: Stigma and lack of knowledge are barriers to clinicians when caring for individuals with opioid use disorder (OUD). In 2018, only about 15 out of 180 American medical schools had comprehensive addiction programs. The AAMC reports that institutions are increasingly incorporating competencies to address the OUD and opioid epidemic. There have been few evaluated curriculums focused on reducing stigmatizing attitudes. This study evaluated whether a 4-hour case-based curriculum focused on improving stigmatizing attitudes toward patients with OUD could reduce medical student perceptions around viewing addiction as a punitive condition and other substitution-based misconceptions around opioid agonist-based medication.

Methods: Medical students completed a 4-hour curricular workshop which included learning objectives focusing on barriers to healthcare/stigmatizing attitudes, effective behavioral therapy options, and appropriate use of opioid medications. We measured changes in knowledge and attitudes using validated scales on stigma. Non-parametric repeated measure tests determined statistically significant differences between pre and post assessments between OUD related perceptions and a control condition (diabetes).

Results: Of 135 eligible participants, 99 (76%) students completed both pre- and post-surveys. Mean scores across knowledge questions improved (60%-81%, P < .001) and stigmatizing attitudes regarding perceived violence of people with OUD decreased (2.04-1.82, P = .016). There was significant improvement in mean scores for OUD-related opinions including desire to work with and effectively treat patients with OUD (3.58-3.88, P < .001) while no significant concurrent change was observed in mean opinion scores of a non-OUD comparator, diabetes (3.88-3.97, P = .201).

Conclusions: Results indicate that the workshop was associated with measurable changes in knowledge and attitudinal forms of OUD stigma. With recent policy changes eliminating the X-waiver, healthcare institutions are eager to design curriculum around OUD management and treatment. This study provides a blueprint for an effective curriculum that improves clinician knowledge and reduces stigmatizing attitudes.

提高医学生对治疗阿片类药物使用障碍患者的认识,减少对患者的轻蔑态度。
目标:污名化和知识匮乏是临床医生治疗阿片类药物使用障碍(OUD)患者的障碍。2018 年,在 180 所美国医学院校中,只有约 15 所开设了综合成瘾课程。美国医学会报告称,越来越多的机构正在纳入应对 OUD 和阿片类药物流行的能力。很少有经过评估的课程侧重于减少轻蔑态度。本研究评估了以改善对 OUD 患者的鄙视态度为重点的 4 小时案例课程是否能减少医学生将成瘾视为一种惩罚性疾病的看法,以及对阿片类激动剂药物治疗的其他替代性误解:医科学生完成了一个 4 小时的课程研讨会,其中包括以医疗保健障碍/轻蔑态度、有效的行为疗法选择和阿片类药物的适当使用为重点的学习目标。我们使用经过验证的成见量表测量了知识和态度的变化。非参数重复测量检验确定了与 OUD 相关的认知和对照条件(糖尿病)在前后评估之间的统计学显著差异:在 135 名符合条件的参与者中,99 名(76%)学生完成了前后两次调查。知识问题的平均得分有所提高(60%-81%,P P = .016)。与 OUD 相关的观点,包括希望与 OUD 患者合作并有效治疗 OUD 患者的观点的平均得分有了明显提高(3.58-3.88,P P = .201):研究结果表明,该讲习班与 OUD 耻辱化的知识和态度形式的可测量变化有关。随着最近取消 X-waiver 的政策变化,医疗机构迫切希望围绕 OUD 管理和治疗设计课程。本研究提供了一个有效的课程蓝图,可提高临床医生的知识水平并减少污名化态度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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