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VCU Chronic Nonmalignant Pain Management : An Online Curriculum

VCU Chronic Nonmalignant Pain Management : An Online Curriculum. Leanne M. Yanni, MD Creator & Editor VCU Medical Center November 16 th , 2007. Background. Managing Pain is challenging Spans professions and specialties Variation in chronic pain syndromes

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VCU Chronic Nonmalignant Pain Management : An Online Curriculum

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  1. VCU Chronic Nonmalignant Pain Management: An Online Curriculum Leanne M. Yanni, MD Creator & Editor VCU Medical Center November 16th, 2007

  2. Background • Managing Pain is challenging • Spans professions and specialties • Variation in chronic pain syndromes • Limited evidence-based guidelines • Limited provider training • Provider fears of legal ramifications Upshur et al 2006; Chen et al 2006; Adams et al 2001

  3. IM Resident Chart Review • Inconsistent documentation of pain assessment and past history • Underutilization of a multi-modal approach to treatment • Underutilization of important clinical practice tools • Assist in recognizing and/or averting misuse Yanni et al 2006 (abstract)

  4. IM Resident Attitudes • Over half reported their experience negatively impacted their view of primary care • Nearly all residents were less confident in their ability to treat pain than other conditions • Over half rated preparation as fair or poor • No resident found treatment of pain rewarding Weaver et al 2005 (abstract); Chen et al 2007

  5. System Interventions to standardize opioid prescribing and monitoring • Pain clinic in the Internal Medicine resident practice • Development of pain curriculum

  6. Curriculum Aims • Improve knowledge of chronic nonmalignant pain • Improve attitudes towards managing patients with chronic nonmalignant pain • Offer ongoing access to practice resources • Ease practice challenges

  7. The Process • Assembled interdisciplinary team of writers • Developed outline and objectives • Wrote content and developed resources • Partnered with VCU SOM to design web module • Recruited national reviewers • Initiated educational studies in medical students and residents

  8. Completion to Date

  9. Course Evaluation Questions • Having completed the curriculum will you access any of the resources? • Is the assessment and treatment of patients with CNMP more important to you as a result of using this curriculum? • As a result of the curriculum, will you make any changes in your behavior or practice? • Would you recommend this curriculum to your colleagues?

  10. % Yes to Evaluation Questions

  11. Reviewer Data • If so, what changes? • “Change medication agreement, use urine drug screening.” • “Change contract and procedure for follow-up.” • “Use template. Specific appointments for pain.” • “Create standardized office visit forms, different urine screening policy and procedures, update my own lecture.” • “Many…”

  12. Resident Data • If so, what changes? • “I will not assume that everyone is ‘drug seeking.’ ” • “Increased utilization of multimodal approach to chronic pain.” • “More frequent office visits for patients with pain, more thorough evaluation prior to starting meds…” • “Careful prescribing habits regarding complete documentation.”

  13. Current Applications • VCU GME programs • VCU SOM undergraduate curriculum • GME and undergraduate medical schools outside of Virginia • VCU School of Pharmacy • Virginia Providers • Supported by DHP

  14. Aims of Partnership with DHP • Provide accessible resources for pain education • Create a Virginia-specific module to outline responsibilities and legalities • Highlight Virginia specific resources • Virginia’s Prescription Monitoring Program (PMP)

  15. The Curriculum • Access through DHP www.dhp.virginia.gov • Create LMS account • Register for course activity • Use valid license number • Access code: “Virginia Pain” • Review Navigation Instructions

  16. Future Directions • Analyze data from educational studies • Evaluate usefulness for Virginia Providers • Extend use in training programs • All professions and specialties • Partner with other organizations on a regional or national level for pain education

  17. The Curriculum Team: Design • John Priestley, MA • Instructional design, web design & development • Joel Browning • Learning Management System, web programming & administration • Chris Stephens • Web programming and administration • Jeanne Schlesinger, Med • Project management, instructional design, and photography

  18. The Curriculum Team: Content • Leanne Yanni, MD • Creator, Editor, & Content Contributor • lyanni@mcvh-vcu.edu • Betty Anne Johnson, MD, PhD • Laura Morgan, PharmD • Mike Weaver, MD • Sarah Beth Harrington, MD • Christine Huynh, MD • Carl Wolf, PhD

  19. VCU Chronic Nonmalignant Pain Managementwww.dhp.virginia.gov License Number Access code: “Virginia Pain”

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