OBJECTIVE: To identify gaps in residents' confidence and knowledge in managing chronic nonmalignant pain (CNMP) and to explore whether specific skills or pain knowledge was associated with global preparedness to manage CNMP. DESIGN: Cross-sectional web-based survey. SETTING AND PARTICIPANTS: Internal medicine residents in Bronx, NY. MAIN OUTCOME MEASURES: The authors assessed the following: 1) confidence in skills within the following four content areas: physical examination, diagnosis, treatment, and safer opioid prescribing; 2) pain-related knowledge on a 16-item scale; and 3) global preparedness to manage CNMP (agreement with, "I feel prepared to manage CNMP"). Gaps in confidence were skills in which fewer than 50 percent reported confidence. Gaps in knowledge were items in which fewer than 50 percent answered correctly. Using logistic regression, the authors examined whether skills or knowledge was associated with global preparedness. RESULTS: Of 145 residents, 92 (63 percent) responded. Gaps in confidence included diagnosing fibromyalgia, performing corticosteroid injections, and using pain medication agreements. Gaps in knowledge included pharmacotherapy for neuropathic pain and interpreting urine drug test results. Twenty-four residents (26 percent) felt globally prepared to manage CNMP. Confidence using pain medication agreements (adjusted odds ratio [AOR], 5.99; 95% confidence interval [CI], 2.02-17.75), prescribing long-acting opioids (AOR, 5.85; 95% CI, 2.00-17.18), and performing corticosteroid injection of the knee (AOR, 5.76; 95% CI, 1.16-28.60]) were strongly associated with global preparedness. CONCLUSIONS: Few internal medicine residents felt prepared to manage CNMP. Our findings suggest that educational interventions to improve residents' preparedness to manage CNMP should target complex pain syndromes (eg, fibromyalgia and neuropathic pain), safer opioid prescribing practices, and alternatives to opioid analgesics.
OBJECTIVE: To identify gaps in residents' confidence and knowledge in managing chronic nonmalignant pain (CNMP) and to explore whether specific skills or pain knowledge was associated with global preparedness to manage CNMP. DESIGN: Cross-sectional web-based survey. SETTING AND PARTICIPANTS: Internal medicine residents in Bronx, NY. MAIN OUTCOME MEASURES: The authors assessed the following: 1) confidence in skills within the following four content areas: physical examination, diagnosis, treatment, and safer opioid prescribing; 2) pain-related knowledge on a 16-item scale; and 3) global preparedness to manage CNMP (agreement with, "I feel prepared to manage CNMP"). Gaps in confidence were skills in which fewer than 50 percent reported confidence. Gaps in knowledge were items in which fewer than 50 percent answered correctly. Using logistic regression, the authors examined whether skills or knowledge was associated with global preparedness. RESULTS: Of 145 residents, 92 (63 percent) responded. Gaps in confidence included diagnosing fibromyalgia, performing corticosteroid injections, and using pain medication agreements. Gaps in knowledge included pharmacotherapy for neuropathic pain and interpreting urine drug test results. Twenty-four residents (26 percent) felt globally prepared to manage CNMP. Confidence using pain medication agreements (adjusted odds ratio [AOR], 5.99; 95% confidence interval [CI], 2.02-17.75), prescribing long-acting opioids (AOR, 5.85; 95% CI, 2.00-17.18), and performing corticosteroid injection of the knee (AOR, 5.76; 95% CI, 1.16-28.60]) were strongly associated with global preparedness. CONCLUSIONS: Few internal medicine residents felt prepared to manage CNMP. Our findings suggest that educational interventions to improve residents' preparedness to manage CNMP should target complex pain syndromes (eg, fibromyalgia and neuropathic pain), safer opioid prescribing practices, and alternatives to opioid analgesics.
Authors: G C Wickstrom; M M Kolar; T C Keyserling; D K Kelley; S X Xie; B A Bognar; C L Lewis; C T DuPre Journal: J Gen Intern Med Date: 2000-06 Impact factor: 5.128
Authors: Leanne M Yanni; Jessica L McKinney-Ketchum; Sarah B Harrington; Christine Huynh; Saad Amin Bs; Robin Matsuyama; Patrick Coyne; Betty A Johnson; Mark Fagan; Linda Garufi-Clark Journal: J Grad Med Educ Date: 2010-06
Authors: Roger Chou; Gilbert J Fanciullo; Perry G Fine; Jeremy A Adler; Jane C Ballantyne; Pamela Davies; Marilee I Donovan; David A Fishbain; Kathy M Foley; Jeffrey Fudin; Aaron M Gilson; Alexander Kelter; Alexander Mauskop; Patrick G O'Connor; Steven D Passik; Gavril W Pasternak; Russell K Portenoy; Ben A Rich; Richard G Roberts; Knox H Todd; Christine Miaskowski Journal: J Pain Date: 2009-02 Impact factor: 5.820
Authors: Judith I Tsui; Alexander Y Walley; Debbie M Cheng; Marlene C Lira; Jane M Liebschutz; Leah S Forman; Margaret M Sullivan; Jonathan Colasanti; Christin Root; Kristen O'Connor; Christopher W Shanahan; Carly L Bridden; Carlos Del Rio; Jeffrey H Samet Journal: AIDS Care Date: 2019-01-11
Authors: Joanna L Starrels; Bryan Wu; Deena Peyser; Aaron D Fox; Abigail Batchelder; Frances K Barg; Julia H Arnsten; Chinazo O Cunningham Journal: J Opioid Manag Date: 2014 Mar-Apr
Authors: Marlene C Lira; Judith I Tsui; Jane M Liebschutz; Jonathan Colasanti; Christin Root; Debbie M Cheng; Alexander Y Walley; Meg Sullivan; Christopher Shanahan; Kristen O'Connor; Catherine Abrams; Leah S Forman; Christine Chaisson; Carly Bridden; Melissa C Podolsky; Kishna Outlaw; Catherine E Harris; Wendy S Armstrong; Carlos Del Rio; Jeffrey H Samet Journal: HIV Res Clin Pract Date: 2019-04
Authors: Joanna G Katzman; Chris Fore; Snehal Bhatt; Nina Greenberg; Julie Griffin Salvador; George C Comerci; Christopher Camarata; Lisa Marr; Rebecca Monette; Sanjeev Arora; Andrea Bradford; Denise Taylor; Jenny Dillow; Susan Karol Journal: Am J Public Health Date: 2016-05-19 Impact factor: 9.308
Authors: Karen E Lasser; Christopher Shanahan; Victoria Parker; Donna Beers; Ziming Xuan; Orlaith Heymann; Allison Lange; Jane M Liebschutz Journal: J Subst Abuse Treat Date: 2015-07-15
Authors: Hariharan Regunath; Kelly Cochran; Kasey Cornell; James Shortridge; Daniel Kim; Syed Akbar; Barbara Boshard; Rebecca Chitima-Matsiga; Jyotsna Reddy; Steven Keithahn; James P Koller Journal: Mo Med Date: 2016 Jan-Feb
Authors: Jason M Moss; William E Bryan; Loren M Wilkerson; Heather A King; George L Jackson; Ryan K Owenby; Courtney H Van Houtven; Melissa B Stevens; James Powers; Camille P Vaughan; William W Hung; Ula Hwang; Alayne D Markland; Richard Sloane; William Knaack; Susan Nicole Hastings Journal: J Pharm Pract Date: 2017-12-25
Authors: Scott M Fishman; Daniel B Carr; Beth Hogans; Martin Cheatle; Rollin M Gallagher; Joanna Katzman; Sean Mackey; Rosemary Polomano; Adrian Popescu; James P Rathmell; Richard W Rosenquist; David Tauben; Laurel Beckett; Yueju Li; Jennifer M Mongoven; Heather M Young Journal: Pain Med Date: 2018-03-01 Impact factor: 3.750