C1 - 05: COMBATING THE OPIOID EPIDEMIC THROUGH PAIN MANAGEMENT TRAINING OF SURGICAL INTERNS
Michael Nooromid, MD, Neel A Mansukhani, MD, Simon Moradian, MD, Jonah J Stulberg, MD, PHD, MPH, Nabil Issa, MD; Northwestern University
Introduction: Currently, educational exposure to pain management and opioid abuse curriculum in medical schools is variable. In this study, we assessed incoming surgical interns’ exposure to these topics in medical school and examined if an educational postoperative pain control session would change their prescribing practices.
Methods: We conducted an educational, clinical scenario-based postoperative pain management session during pre-residency training among 22 incoming surgical interns at a single urban medical center. A pre-session survey was administered to assess educational exposure to pain management and opioid abuse education in medical school and to assess postoperative prescription patterns for eight mock clinical scenarios. The educational session was then followed by a post-session survey including mock clinical scenarios.
Results: 77% of interns had exposure to opioid abuse sessions in medical school, while 32% had exposure to safe opioid prescribing practice. Prior to the postoperative pain management session, 69% of the mock patients were prescribed a non-opioid analgesic, compared to 98% of mock patients in the post-session survey (P<0.001). Meanwhile, prior to the postoperative pain management session, 60% of the mock patients were prescribed an opioid analgesic, compared to 49% of mock patients in the post-session survey (P=0.12). The mean morphine equivalents prescribed for all procedures in the pre-session survey was 104 mg (95% CI 76-133), which decreased to 31 mg in the post-session survey (95% CI 24-38) (P<0.0001). 100% of the interns responded that the session was helpful. Overall, 86% of interns said they would prescribe a smaller quantity of opioids after the educational session, while 14% of interns said their prescribing practices would be unchanged.
Conclusion: The majority of the incoming surgical interns were exposed to opioid abuse sessions in medical school, however, most did not receive training in safe opioid prescribing practices. A pre-residency postoperative pain management session had a significant effect on mock postoperative prescriptions. Overall, the percentage of interns prescribing an opioid and the quantity of opioids prescribed decreased after training, while the use of non-opioid analgesics increased. Further evaluation is necessary to determine if these habits were sustained after the start of training.