An epidemic of addiction to prescription pain medications now causes deaths due to overdose that outnumber automobile-related deaths, rising admissions to hospitals, and disrupted lives for both the patient and family. The White House Office of National Drug Control Policy (ONDCP) report, Epidemic: Responding to America's Prescription Drug Abuse Crisis, highlights the crisis and calls for health care professional education in the proper use of opioids;required education related to opioid pain medications appears inevitable. Intended Impact: This project responds to this call by: 1) creating a continuing health professional development (CHPD) program using an On-Line Interactive Virtual Environment (OLIVE) with virtual patient scenarios, and 2) evaluating the products'ability to alter provider behavior relevant to decreasing the prescription opioid epidemic. The new product will be a part of the existing, successful, which was developed with support from a NIDA contract, and is produced via a partnership between the Association for Medical Education on Substance Abuse (AMERSA) and Clinical Tools. We expect:" Providers will enhance their clinical skills and test practice change through deliberate practice via OLIVE's simulated (i.e., computer-generated) patients. The planned program will test their skills and provide automated feedback, guidance and direction. "Clinic leaders and health care organizations can implement a comprehensive CHPD program."The health professional education community will gain important data regarding the potential of novel virtual environment technology to instill new behaviors and effect practice change. Phase I demonstrates product feasibility and the acceptability of proceeding with Phase II by: 1) completing target audience needs analysis surveys and semi-structured interviews;2) creating a training framework for OLIVE-based CHPD training on the proper use of opioids;3) outlining assessments to be used in the Phase II evaluative study of OLIVE vs. web-based training;4) developing a prototype OLIVE training experience;and, 5) demonstrating acceptability and feasibility and recruiting clinic locations for the Phase II study. Phase II completes the program based on content already found in our previously developed product's ( interactive case-based instruction, clinical questions, resources and implementation guides. After finalizing clinic participation for the summative study, the project evaluates the CHPD program using a randomized, active control design of OLIVE-based training vs. that compares change in competency, performance, clinical, and communication skills and improved treatment behavior related to opioid prescribing and pain patient assessment for addiction risk.

Public Health Relevance

The treatment of pain with prescription pain medications is now a significant cause of an epidemic of prescription drug abuse leading to overdose deaths, the downward spiral of addiction, diversion to the public, increased costs, and decreased productivity. We must prepare health professionals with the skills to intervene in pain without causing undo harm by altering how they evaluate patients in pain and provide treatment. This product will enhance the skills of health care providers via a virtual clinical encounter where the can develop proper pain management and opioid risk assessment and intervention skills including: screening for pain treatment red flags and addiction history, full assessment and diagnosis of pain etiology and addiction, providing treatment interventions that minimize risk of addiction and diversion, and referral to a specialist in pain control and/or addiction when necessary. Health professionals who are more proficient in core competencies before and after prescribing a pain medication will reduce the suffering and costs of addiction to prescription pain medications.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1-RPHB-C (10))
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Denisco, Richard A
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Clinical Tools, Inc.
Chapel Hill
United States
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