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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Methods of Documentation II: POMR01:26

Methods of Documentation II: POMR

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The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
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Need for Structured Pain Management Curriculum and Competency-Based Evaluation in GME: An Observational Study in One

Sudhagar Thangarasu1, Gowri Renganathan1, Barney Soskin1

  • 1Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso-The Hospitals of Providence Transmountain campus, El Paso, Texas, USA.

Journal of Medical Education and Curricular Development
|November 15, 2024
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Summary

Hospital admission, not patient factors, significantly increases opioid prescriptions. This highlights the need for better pain management training in residency programs to address the opioid crisis.

Keywords:
Pain management curriculumcompetency-based evaluationmultimodal approach to pain managementopioid stewardshipstructured curriculum

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Area of Science:

  • Internal Medicine
  • Pain Management
  • Opioid Prescribing Practices

Background:

  • The opioid crisis is exacerbated by inadequate adherence to guideline-based pain management.
  • Residency training curricula often lack comprehensive pain management education.
  • Understanding opioid exposure during hospitalization is crucial for intervention.

Purpose of the Study:

  • To assess the prevalence of opioid exposure among hospitalized patients.
  • To examine associations between patient demographics, disease conditions, and opioid prescriptions.
  • To identify key determinants of opioid use during acute care.

Main Methods:

  • Retrospective cohort study.
  • Analysis of medical records for 2272 patients admitted to an internal medicine teaching service.
  • Data collected from September 2017 to September 2018 at a southern California county teaching hospital.

Main Results:

  • 44% of patients received opioid prescriptions during hospitalization; 23% at discharge.
  • 45% of patients had prior opioid exposure, with a 2-fold increased risk of discharge prescription.
  • Hospital admission, not patient-specific factors, was the significant determinant for opioid prescriptions.

Conclusions:

  • Inpatient admission is the primary driver of opioid exposure, overriding patient-related factors.
  • The default use of opioids for pain suggests a need for curricular reform in residency training.
  • Implementing multimodal pain management principles is essential to combat inappropriate opioid prescribing.