SRF022: Evaluation of a Peer-to-Peer Intervention in Opioid Prescribing Practice within a US Family Medicine Residency Program

Leora Aquino; Julie Phillips, MD, MPH


Context: According to the U.S. Department of Health and Human Services, opioid overdoses accounted for more than 42,000 deaths in 2016, 40% of which were due to prescription opioids. In light of this public health crisis, there is a need to equip family medicine providers with tools, skills, and knowledge to safely prescribe opioids. However, there is little existing literature about educational methods for safe opioid prescribing, particularly among residents. We seek to address this through a mixed-methods study evaluating the effectiveness of a peer review opioid prescribing intervention.
Objective: To assess the effectiveness of a peer review opioid prescribing intervention across a series of peer review cycles.
Human Subject Review: Minimal Risk, Exempt
Study Design: Mixed-methods study design (qualitative interviews, survey, and chart review) Setting or Dataset: Family Medicine Residency Program in Midwestern United States
Setting: Approximately 30 Family Medicine residents participating in the peer review opioid prescribing educational intervention who consent to be studied. Approximately 60 patient charts will be reviewed.
Intervention/Instrument: Small group peer-to-peer discussion of patients being prescribed opioids, with guidance of faculty and pharmacist, using a structured approach to evaluation and care recommendations.
Outcome Measures: Change in practice following recommendations, as documented in chart review. Overall practice changes in opioid prescribing over the period of review. Resident perceptions of usefulness of educational intervention and perceptions of learning.
Results: Charts will be reviewed to evaluate whether specific recommendations were followed after the peer review intervention. A correlation analysis of the number of recommendations made and the likelihood of following those recommendations will be conducted. Qualitative interviews will be analyzed by two researchers to identify emergent themes describing residents’ perceived learning.
Expected Outcomes:
Study will describe effectiveness of educational intervention in facilitating practice change. Specifically, we will report which recommendations are most likely to be made and followed. We will assess whether recommendations made were consistent with CDC guidelines. We will also qualitatively describe residents’ experience with the educational intervention.
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Liz Sturgiss 11/20/2020

Thank you for your poster - I’m wondering if you can tell me about opioid replacement therapy in your setting? Is it difficult to access? (E.g. Methadone)

Jack 11/21/2020

terrific work. looking forward to learning more as you move forward. thanks

Tyler Barreto

Great work and presentation! Thank you for sharing. I look forward to finding out if this peer-reviewed approach is effective. It would be particularly interesting to see if there are long term benefits -- for example, will you see CDC guidelines being followed more closely over time? Will there be a drop off of this learning - will they follow guidelines strictly for the first few months and then slowly loosen back to baseline? Much to be learned from this work. Thank you!

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