Presented at the 2012 AAPM Annual Meeting « Back

Identification of Key Gaps in Opioid Prescriber Knowledge with an Industry-Sponsored REMS Credentialing Test

Maria Frazer, BS, maria_frazer@urmc.rochester.edu¹, John Markman, MD², Rui Hu, PhD³, Mackenzie A. Tsang-Lee¹, Katarzyna Czerniecka, MD¹, (1) University of Rochester, Rochester, New York, (2) Department of Neurosurgery, University of Rochester School of Medicine, Rochester, New York, (3) Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York

Introduction: Industry-sponsored educational programs are the centerpiece of FDA-mandated Risk Evaluation and Mitigation Strategy (REMS) for long-acting opioid medication. This cross sectional survey identifies key gaps in knowledge related to opioid pharmacology and risk management practices among a diverse group of clinicians who routinely prescribe this class of medication. Methods: A questionnaire related to opioid prescribing with an embedded subset of post-test items from the program of a long-acting opioid manufacturer was administered to 31 prescribers (13 MDs, 2 DOs, 15 NPs, 1 PA) in attendance at a regional pain management conference. Survey items included multiple choice questions pertaining to fund of knowledge, attitude, and current practice. These data represent a baseline dataset for the participants in this educational activity. Results: Sixty-eight percent of respondents answered fewer than five of seven post-test questions correctly. Ninety-seven percent of prescribers incorrectly answered items pertaining to safe initial titration of an extended release long-acting opioid (ER LAO). Fewer than 60% of prescribers demonstrated an understanding of best practices related to safe storage of ER LAOs. Prescribers who recognized the risks factors for addiction were also more likely to understand the primary risks of ER LAOs (p = 0.02). The associations between responses were tested by Fisher’s exact test. Conclusion: An industry-sponsored REMS post-test identifies key knowledge gaps in clinicians who routinely prescribe opioids. Based on these preliminary results, educational programs and credentialing programs should emphasize fund of knowledge deficits related to initial titration and safe storage of long-acting opioid products.

Funding: This research was partially funded by a grant from Endo Pharmaceuticals.