Evaluating the Impact of Pain Management (PM) Education on Physician Practice Patterns—A Continuing Medical Education (CME) Outcomes Study

摘要

California Assembly Bill AB487 mandates that all practicing physicians are required to obtain 12 h of Continuing Medical Education in Pain Management and End of Life Care before the year 2006 in order to renew their state license to practice medicine. In order to determine the effectiveness of this bill in influencing the practice of medicine, we conducted the first of five planned annual Pain Management seminars and utilized physician questionnaires to determine possible practice changes as a result of this seminar. Eighty-one physicians representing 17 multiple specialties of medicine enrolled in this seminar. The topics included: management of malignant and non-malignant pain, pharmacology and management of side effects of opiate and non-opiate analgesics, and adjunctive therapies including depression management and spirituality issues. Physicians were asked to respond to an immediate post-seminar questionnaire and were subsequently queried 4 months following the conference. Fifty-one out of 81 physician registrants responded to an immediate post-attendance questionnaire, and 31 responded to the 4-month follow-up questionnaire. Responses included: class="array small">> colspan="3" valign="bottom" rowspan="1">

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> valign="top" align="left" rowspan="1" colspan="1"> valign="top" align="left" rowspan="1" colspan="1">Early valign="top" align="left" rowspan="1" colspan="1">Late> align="left" valign="top" rowspan="1" colspan="1">I will change/have changed my practice align="left" valign="top" rowspan="1" colspan="1">34 align="left" valign="top" rowspan="1" colspan="1">28> align="left" valign="top" rowspan="1" colspan="1">I see no need to change my practice align="left" valign="top" rowspan="1" colspan="1">6 align="left" valign="top" rowspan="1" colspan="1">2> align="left" valign="top" rowspan="1" colspan="1">I will await further information align="left" valign="top" rowspan="1" colspan="1">7 align="left" valign="top" rowspan="1" colspan="1">1> align="left" valign="top" rowspan="1" colspan="1">No response regarding practice change align="left" valign="top" rowspan="1" colspan="1">4 align="left" valign="top" rowspan="1" colspan="1">> colspan="3" align="left" valign="top" rowspan="1">Responses of those who changed their practices included:> align="left" valign="top" rowspan="1" colspan="1"> Increased use of known modalities for pain control align="left" valign="top" rowspan="1" colspan="1"> align="left" valign="top" rowspan="1" colspan="1">21> align="left" valign="top" rowspan="1" colspan="1"> Earlier referrals to specialists align="left" valign="top" rowspan="1" colspan="1"> align="left" valign="top" rowspan="1" colspan="1">14> align="left" valign="top" rowspan="1" colspan="1"> More attention to psychosocial aspects align="left" valign="top" rowspan="1" colspan="1"> align="left" valign="top" rowspan="1" colspan="1">14> align="left" valign="top" rowspan="1" colspan="1"> Use of new drugs/modalities of care align="left" valign="top" rowspan="1" colspan="1"> align="left" valign="top" rowspan="1" colspan="1">11> colspan="3" valign="bottom" rowspan="1">

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This audience represents the most motivated group of practitioners electing to receive Pain Management Education long before the mandated deadline. Sixty-seven percent expressed an interest in changing their practice following this intensive educational experience. Ninety percent responding to the follow-up evaluation indicated that their practices had changed, suggesting that this seminar series is effective in altering physician practice patterns (supported by Cancer Center Support Grant CA 33572 and Sarnat Foundation).