Opioid prescriptions following behavioral health training among primary care providers
Abstract Background Overdose deaths due to opioids are a major concern in the United States. Physicians often report inadequate training in chronic pain and substance use disorder management. Here, we evaluate whether a specialized program, the Train New Trainers Primary Care Psychiatry (TNT PCP) Fe...
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BMC
2024-11-01
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| Series: | BMC Medical Education |
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| Online Access: | https://doi.org/10.1186/s12909-024-06289-y |
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| author | Shutong Huo Tim A. Bruckner Abhery Das Glen L. Xiong David Marcovitz Ariel B. Neikrug Robert McCarron |
| author_facet | Shutong Huo Tim A. Bruckner Abhery Das Glen L. Xiong David Marcovitz Ariel B. Neikrug Robert McCarron |
| author_sort | Shutong Huo |
| collection | DOAJ |
| description | Abstract Background Overdose deaths due to opioids are a major concern in the United States. Physicians often report inadequate training in chronic pain and substance use disorder management. Here, we evaluate whether a specialized program, the Train New Trainers Primary Care Psychiatry (TNT PCP) Fellowship, affected opioid prescription practices among primary care physicians. Methods We retrieved information from a publicly insured health program in Southern California on 11,975 patients and 180 primary care providers (PCPs) engaged in care between 2017 and 2021. Of the 180 PCPs, 38 received TNT training and 142 did not. We considered a patient as exposed to the provider’s TNT “treatment” if they received care from a provider after the provider completed the 1-year fellowship. We utilized the number of opioid prescriptions per patient per quarter-year as the key independent variable. Linear regression models controlled for provider characteristics and time trends. Robustness checks included clustering patients by provider identification. Results Post-TNT training, PCPs prescribed fewer than expected opioids. This result remains robust after controlling for several covariates (coef: − 0.209 ; standard error = 0.052, p < 0.001) as well as after clustering patient observations by provider. Conclusion In a large Southern California healthcare system, the TNT training program preceded a reduction in primary care providers’ prescription rates of opioids. If replicated in larger samples, a low-cost provider training program has the potential to promote more judicious use of opioids for pain management. We encourage more studies to understand the program’s long-term impact on physician behavior and, potentially, on patient outcomes. |
| format | Article |
| id | doaj-art-2bb97f28a0084de2bc538c74a7e6447e |
| institution | Kabale University |
| issn | 1472-6920 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj-art-2bb97f28a0084de2bc538c74a7e6447e2024-12-01T12:31:37ZengBMCBMC Medical Education1472-69202024-11-012411910.1186/s12909-024-06289-yOpioid prescriptions following behavioral health training among primary care providersShutong Huo0Tim A. Bruckner1Abhery Das2Glen L. Xiong3David Marcovitz4Ariel B. Neikrug5Robert McCarron6Department of Health, Society, and Behavior, UC Irvine Joe C. Wen School of Population & Public HealthDepartment of Health, Society, and Behavior, UC Irvine Joe C. Wen School of Population & Public HealthHeath Policy & Administration, School of Public Health, University of Illinois ChicagoUniversity of California, Davis, Psychiatry and Behavioral SciencesDepartment of Psychiatry and Behavioral Sciences, Vanderbilt University Medical CenterDepartment of Psychiatry and Human Behavior, University of California Irvine School of MedicineDepartment of Psychiatry and Human Behavior, University of California Irvine School of MedicineAbstract Background Overdose deaths due to opioids are a major concern in the United States. Physicians often report inadequate training in chronic pain and substance use disorder management. Here, we evaluate whether a specialized program, the Train New Trainers Primary Care Psychiatry (TNT PCP) Fellowship, affected opioid prescription practices among primary care physicians. Methods We retrieved information from a publicly insured health program in Southern California on 11,975 patients and 180 primary care providers (PCPs) engaged in care between 2017 and 2021. Of the 180 PCPs, 38 received TNT training and 142 did not. We considered a patient as exposed to the provider’s TNT “treatment” if they received care from a provider after the provider completed the 1-year fellowship. We utilized the number of opioid prescriptions per patient per quarter-year as the key independent variable. Linear regression models controlled for provider characteristics and time trends. Robustness checks included clustering patients by provider identification. Results Post-TNT training, PCPs prescribed fewer than expected opioids. This result remains robust after controlling for several covariates (coef: − 0.209 ; standard error = 0.052, p < 0.001) as well as after clustering patient observations by provider. Conclusion In a large Southern California healthcare system, the TNT training program preceded a reduction in primary care providers’ prescription rates of opioids. If replicated in larger samples, a low-cost provider training program has the potential to promote more judicious use of opioids for pain management. We encourage more studies to understand the program’s long-term impact on physician behavior and, potentially, on patient outcomes.https://doi.org/10.1186/s12909-024-06289-yOpioid prescribing behaviorPsychiatric TrainingPrimary care providersSubstance Use disordersOpioid Crisis |
| spellingShingle | Shutong Huo Tim A. Bruckner Abhery Das Glen L. Xiong David Marcovitz Ariel B. Neikrug Robert McCarron Opioid prescriptions following behavioral health training among primary care providers BMC Medical Education Opioid prescribing behavior Psychiatric Training Primary care providers Substance Use disorders Opioid Crisis |
| title | Opioid prescriptions following behavioral health training among primary care providers |
| title_full | Opioid prescriptions following behavioral health training among primary care providers |
| title_fullStr | Opioid prescriptions following behavioral health training among primary care providers |
| title_full_unstemmed | Opioid prescriptions following behavioral health training among primary care providers |
| title_short | Opioid prescriptions following behavioral health training among primary care providers |
| title_sort | opioid prescriptions following behavioral health training among primary care providers |
| topic | Opioid prescribing behavior Psychiatric Training Primary care providers Substance Use disorders Opioid Crisis |
| url | https://doi.org/10.1186/s12909-024-06289-y |
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