Changes in primary care provider behaviors after a brief educational intervention about opioid prescribing in older adults.

Abstract

Background: There is limited literature on educational interventions for primary care clinicians (PCC) addressing the unique considerations in opioid prescribing for older adult patients.

Objective: We aimed to evaluate self-reported knowledge, confidence, and behavior change by PCC and the degree to which respondents followed through with their intentions to implement specific clinical strategies after receiving a brief educational intervention about opioid prescribing in older adults.

Design: Analysis of pre-, post-, and one-month follow-up surveys of PCC.

Participants: PCC working within our institution's 13 primary care clinics.

Interventions: The brief educational training was conducted over 20 months and focused on limited benefits and unique harms of chronic opioid use in older adults, opioid use disorder screening, and harm reduction strategies.

Main measures: The surveys assessed perceived knowledge and confidence in non-opioid medication options and opioid safety strategies before and after the intervention and potential use of strategies to address opioid use in their clinical practice. The one-month follow-up survey asked if participants had started implementing opioid safety strategies with patients. We also collected information on age, gender, race, ethnicity, and health professions discipline.

Key results: Sixty-five PCC received the intervention and completed the immediate post-training survey. Of these, 24 also completed the one-month follow-up survey. We found increased perceived knowledge of the effectiveness of long-term opioids for chronic pain and increased confidence in suggesting non-opioid treatment options among all participants after the training. Post-training, all but one clinician planned to implement at least one of the taught opioid safety strategies. At one-month follow-up, depending on the strategy, between 10%-78% of participants had implemented their planned strategy.

Conclusions: Our findings show that a brief opioid-focused educational intervention for practicing PCC is associated with increased perceived knowledge and confidence immediately after the intervention and a high likelihood of implementing some of the taught strategies one month later. These findings suggest that brief trainings may be impactful educational interventions for practicing PCC.