在初级保健提供者进行行为健康培训后,阿片类药物处方
Shutong Huo1, Tim A Bruckner2,3, Abhery Das4
1Department of Health, Society, and Behavior, UC Irvine Joe C. Wen School of Population & Public Health, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA, 92697 - 3957, USA.
BMC medical education
|November 26, 2024
概括
完成培训新教练 (TNT) 奖学金的初级保健医生开的阿片类药物较少. 这种专业培训可能会减少阿片类药物处方来治疗疼痛.
科学领域:
- 医学教育 医学教育
- 公共卫生 公共卫生
- 疼痛管理 疼痛管理
背景情况:
- 在美国,阿片类药物过量死亡是严重的公共卫生问题.
- 医生往往缺乏足够的培训来管理慢性疼痛和物质使用障碍.
- 培训新教练初级保健精神病学 (TNT PCP) 奖学金是一个专门的培训计划.
研究的目的:
- 评估TNT PCP奖学金对初级保健医生 (PCP) 中阿片类药物处方实践的影响.
主要方法:
- 来自南加州卫生计划的11,975名患者和180名PCP的回顾性分析 (2017-2021年).
- 在完成TNT奖学金 (n=38) 和未完成TNT奖学金 (n=142) 的PCP之间,每患者每季度的阿片类药物处方率的比较.
- 利用线性回归模型,控制提供者特征和时间趋势,并进行 robustness 检查,包括集群患者观察.
主要成果:
- 完成TNT奖学金的PCP在培训后处方的阿片类药物明显减少 (系数: -0.209,p < 0.001).
- 在控制共变量和聚类后,这种减少在统计学上仍然显著.
- 在不同的分析方法中,这些发现是稳定的.
结论:
- 在一个大型医疗保健系统中,TNT培训计划与降低阿片类药物处方率有关.
- 低成本的提供者培训计划显示出促进在疼痛管理中明智使用阿片类药物的潜力.
- 鼓励进一步的研究,以探索对医生行为和患者结果的长期影响.
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