Literature DB >> 29179909

Surgical interns: Preparedness for opioid prescribing before and after a training intervention.

Michael J Nooromid1, Neel A Mansukhani2, Benjamin W Deschner3, Simon Moradian4, Nabil Issa5, Karen J Ho6, Jonah J Stulberg7.   

Abstract

INTRODUCTION: Exposure to pain management curriculum in medical school is currently variable. This paper reports on formal prescribing education, self-perceived prescribing readiness, and prescribing practices among incoming surgical residents before and after a pain management training session.
METHODS: Pre-residency survey of thirty surgical interns at a single urban medical center, followed by a repeat survey after an educational session on prescription writing and opioid abuse.
RESULTS: Thirty-three percent of respondents had formal education on prescription writing in medical school. Median subjective preparedness to write an opioid prescription was 1.5 (range 1-10) on a 1-10 Likert scale. Ranges of morphine milligram equivalents (MME) prescribed varied from 420-2700 MME for 8 mock surgical scenarios. Post-training, median subjective preparedness increased to 3.5 (range 1-6) and prescription accuracy (the inclusion of a medication, dose, frequency, and duration) improved from 75% to 97% (p < 0.001). Overall, 90% of interns found the training session useful.
CONCLUSION: Most surgical interns were not trained in prescribing narcotics in medical school. Improved pain management curriculum is necessary to assure safe and consistent opioid prescriptions.
Copyright © 2017 Elsevier Inc. All rights reserved.

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Year:  2017        PMID: 29179909      PMCID: PMC5801131          DOI: 10.1016/j.amjsurg.2017.11.017

Source DB:  PubMed          Journal:  Am J Surg        ISSN: 0002-9610            Impact factor:   2.565


  13 in total

1.  Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice.

Authors:  Cory Bates; Robert Laciak; Andrew Southwick; Jay Bishoff
Journal:  J Urol       Date:  2010-12-18       Impact factor: 7.450

2.  The EVMS pain education initiative: a multifaceted approach to resident education.

Authors:  Ian Chen; Benjamin Goodman; Marissa Galicia-Castillo; Antonio Quidgley-Nevares; Marcia Krebs; Gayle Gliva-McConvey
Journal:  J Pain       Date:  2006-09-01       Impact factor: 5.820

3.  An Educational Intervention Decreases Opioid Prescribing After General Surgical Operations.

Authors:  Maureen V Hill; Ryland S Stucke; Michelle L McMahon; Julia L Beeman; Richard J Barth
Journal:  Ann Surg       Date:  2018-03       Impact factor: 12.969

4.  Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures.

Authors:  Maureen V Hill; Michelle L McMahon; Ryland S Stucke; Richard J Barth
Journal:  Ann Surg       Date:  2017-04       Impact factor: 12.969

5.  Pain education in North American medical schools.

Authors:  Lina Mezei; Beth B Murinson
Journal:  J Pain       Date:  2011-09-25       Impact factor: 5.820

6.  An educational strategy for treating chronic, noncancer pain with opioids: a pilot test.

Authors:  Huda Elhwairis; Christopher B Reznich
Journal:  J Pain       Date:  2010-06-09       Impact factor: 5.820

7.  CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016.

Authors:  Deborah Dowell; Tamara M Haegerich; Roger Chou
Journal:  MMWR Recomm Rep       Date:  2016-03-18

8.  Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management.

Authors: 
Journal:  Anesthesiology       Date:  2012-02       Impact factor: 7.892

9.  Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures.

Authors:  Hans J Gerbershagen; Sanjay Aduckathil; Albert J M van Wijck; Linda M Peelen; Cor J Kalkman; Winfried Meissner
Journal:  Anesthesiology       Date:  2013-04       Impact factor: 7.892

10.  A Call for Better Opioid Prescribing Training and Education.

Authors:  Hazar Khidir; Scott G Weiner
Journal:  West J Emerg Med       Date:  2016-10-03
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  9 in total

Review 1.  A Systematic Review of Pain Management Education in Graduate Medical Education.

Authors:  Zayir Malik; James Ahn; Kathryn Thompson; Alejandro Palma
Journal:  J Grad Med Educ       Date:  2022-04-14

2.  The use of a surgical boot camp combining anatomical education and surgical simulation for internship preparedness among senior medical students.

Authors:  Jifeng Zhang; Prince Last Mudenda Zilundu; Wenbin Zhang; Guangyin Yu; Sumei Li; Lihua Zhou; Guoqing Guo
Journal:  BMC Med Educ       Date:  2022-06-15       Impact factor: 3.263

3.  Clinician training level impacts prescribing practices for the conservative management of acute renal colic: a contemporary update.

Authors:  Liang G Qu; Garson Chan; Johan Gani
Journal:  Int Urol Nephrol       Date:  2020-10-26       Impact factor: 2.370

4.  Preoperative patient education and patient preparedness are associated with less postoperative use of opioids.

Authors:  Rhami Khorfan; Meagan L Shallcross; Benjamin Yu; Nicholas Sanchez; Shelby Parilla; Julia M Coughlin; Julie K Johnson; Karl Y Bilimoria; Jonah J Stulberg
Journal:  Surgery       Date:  2020-02-20       Impact factor: 3.982

Review 5.  Fighting Back: Institutional Strategies to Combat the Opioid Epidemic: A Systematic Review.

Authors:  Francis Lovecchio; Ajay Premkumar; Jeffrey G Stepan; Todd J Albert
Journal:  HSS J       Date:  2019-01-14

6.  Opioids Use and Abuse: Prescription Practice, Attitude, and Beliefs among Doctors of Karachi.

Authors:  Zainab Majid; Mahpara Tanveer; Sarrah Ali Asghar; Faryal Tahir; Areeba Minhaj; Hamza Aijaz Khan; Tehzeeb Sialvi; Syeda Hania Mahmood; Laila Tul Qadar; Fouzia Imtiaz
Journal:  Cureus       Date:  2019-07-27

7.  Variation in Postoperative Opioid Prescribing Among Upper-Extremity Surgery Providers.

Authors:  Christian N Delgado; Imran S Yousaf; Anita Sadhu; Michael M Shipp; Kavya K Sanghavi; Aviram M Giladi
Journal:  J Hand Surg Glob Online       Date:  2020-11-20

8.  Beyond opioid prescribing: Evaluation of a substance use disorder curriculum for OBGYN residents.

Authors:  Caitlin E Martin; Bhushan Thakkar; Lauren Cox; Elisabeth Johnson; Hendrée E Jones; AnnaMarie Connolly
Journal:  PLoS One       Date:  2022-09-15       Impact factor: 3.752

9.  Opioid Knowledge and Prescribing Habits at a Large Tertiary Care Academic Center.

Authors:  Bajaj Prempreet; Megan Brennan; Gregory Grigoropoulos; Adam Hintz; Satyum Parikh; Neha Shah; Amy Wozniak
Journal:  Cureus       Date:  2022-08-10
  9 in total

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