Prescribers or Multidisciplinarians? An Evaluation of Brief Education for General Practitioners on Chronic Pain Management

Authors

  • Simon Mark Holliday School of Medicine and Public Health, University of Newcastle, NSW. http://orcid.org/0000-0002-8392-9696
  • Chris Hayes Lecturer: School of Medicine and Public Health, University of Newcastle, NSW. Director: Hunter Integrated pain Service; Hunter New England Local Health District, Newcastle, NSW.
  • Lester Edmund Jones Singapore Institute of Technology and La Trobe University, Melbourne, Australia http://orcid.org/0000-0002-5520-2334
  • Jill Gordon Avondale College, NSW
  • Catherine Fraser Nil
  • Newman Harris University of Sydney: Pain Management & Research Institute, Sydney, NSW
  • Michael Nicholas University of Sydney: Pain Management Research Institute, Sydney, NSW
  • Carl Holder Hunter Medical Research Institute, Newcastle, NSW
  • Christopher Oldmeadow Hunter Medical Research Institute, Newcastle, NSW
  • Parker Magin School of Medicine and Public Health, University of Newcastle, NSW

DOI:

https://doi.org/10.33966/hepj.3.1.14146

Abstract

Purpose

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

 

Design and Methodology

Having developed an educational training resource, a multidisciplinary team delivered the program to attendees at a GP conference in 2017. The educational package comprised pre-readings, a 6-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 minimization. Paired t-tests were conducted on each domain score and overall, with effect sizes assessed with Cohen’s d. A sensitivity analysis was performed on the data lacking a post-test survey response. Post-survey scores were imputed via chained regression equations, then paired t-tests analyses were conducted on imputed datasets using Rubin's method to pool estimates.

 

Findings

Of 99 participants, 33 returned both surveys for primary analysis. These were combined in the sensitivity analysis with 60 unpaired surveys. Internal consistency was modest (Cronbach’s alpha 0.736). Primary analysis demonstrated significant self-reported improvements in each educational domain with overall score increasing 10.54 points out of 130 (p<0.001 Cohen’s d 1.11). Improvements were similar in a sensitivity analysis.

 

Discussion, Limitations and Conclusions

This study found that a brief GP educational package may be a viable intervention for facilitating PSM and promoting safer prescribing strategies. Outcomes at three months, from this unvalidated survey instrument, suggest improvements in knowledge, attitudes and self-reported facilitation of PSM and opioid prescribing. As this study did not measure clinician behaviour or patient outcomes objectively, further educational research is indicated to confirm these findings and identify how best to deliver chronic pain management training.

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Author Biographies

  • Simon Mark Holliday, School of Medicine and Public Health, University of Newcastle, NSW.

    Conjoint Lecturer, School of Medicine and Public Health, University of Newcastle, NSW.

    General Practitioner, HealthHub Taree, NSW.

    Staff Specialist; Drug and Alcohol Clinical Services, Hunter New England Local Health District, Taree NSW.
  • Lester Edmund Jones, Singapore Institute of Technology and La Trobe University, Melbourne, Australia
    Lecturer, Singapore Institute of Technology
  • Jill Gordon, Avondale College, NSW

    General Practitioner, Roseville, NSW

    Associate Professor (retired)

  • Catherine Fraser, Nil
    General Practitioner, Pymble, NSW (Retired)
  • Newman Harris, University of Sydney: Pain Management & Research Institute, Sydney, NSW

    Psychiatrist, Sydney NSW

    Lecturer, University of Sydney: Pain Management & Research Institute, Sydney, NSW

     

  • Michael Nicholas, University of Sydney: Pain Management Research Institute, Sydney, NSW

    Professor, University of Sydney, NSW

    Clinical Psychologist: Pain Management Research Institute, Sydney, NSW

     

  • Carl Holder, Hunter Medical Research Institute, Newcastle, NSW
    Senior Biostatistician, Hunter Medical Research Institute, Newcastle, NSW
  • Christopher Oldmeadow, Hunter Medical Research Institute, Newcastle, NSW

    Senior Biostatistician, Hunter Medical Research Institute, Newcastle, NSW

  • Parker Magin, School of Medicine and Public Health, University of Newcastle, NSW
    Professor: School of Medicine and Public Health, University of Newcastle, NSW

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Published

2020-08-13

Issue

Vol. 3 No. 1

Section

Articles

How to Cite

Prescribers or Multidisciplinarians? An Evaluation of Brief Education for General Practitioners on Chronic Pain Management. (2020). Health Education in Practice: Journal of Research for Professional Learning, 3(1). https://doi.org/10.33966/hepj.3.1.14146