Abstract of the research

Active pain self-management (PSM) for patients with chronic pain (CP) is assumed to require multidisciplinary care, leaving prescribing analgesics the most accessible option for general practitioners (GPs). As such, we sought to upskill GPs in multimodal PSM with a harm minimisation approach for any opioid prescribing.

What is the purpose of the research?

Chronic pain (CP) is a ubiquitous presenting problem for GPs, frequently complicated with numerous physical or mental complexities. Until recently, GPs were advised, if nothing else worked, to use a judicious trial of opioids. This led to escalating rates of long-term opioid use with parallel increases in overdose presentations to hospitals or deaths.

What did the researchers do?

Having developed an educational training resource, a multidisciplinary team (MDT) delivered the program to attendees at a GP conference in 2017. The educational package comprised pre-readings, a six-hour interactive, skills-based workshop, and post-workshop resources. The single-group intervention was evaluated with an original and unvalidated pre-/post-test (three months) survey of four domains: knowledge, attitudes, utilisation of strategies involving PSM and opioid harm minimisation. Paired t-tests were conducted on each domain score and overall, with effect sizes assessed using Cohen’s d. A sensitivity analysis was performed on the data lacking a post-test survey response. Post-survey scores were imputed using chained regression equations, then paired t-tests analyses were conducted on imputed datasets using Rubin’s method to pool estimates.

What did the researchers find?

There were 99 participants and three months after the training was delivered, the unvalidated pre-/post-test instrument showed significantly improved knowledge, attitudes, and utilisation of Pain Self Management strategies and opioid harm minimisation strategies.

How can the research be used?

This evaluation indicates that brief GP education in multi-modal care generates sustainable changes which may improve outcomes for the common and intersecting problems of CP, addictive pharmacotherapy and multimorbidity.

Read the full research report published in the Health Education in Practice Journal - Vol. 3 | No. 1 | 2020