Mixed methods formative evaluation of a collaborative care program to decrease risky opioid prescribing and increase non-pharmacologic approaches to pain management
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Authors
Becker, William C.Mattocks, Kristin M.
Frank, Joseph W.
Bair, Matthew J.
Jankowski, Rebecca L.
Kerns, Robert D.
Painter, Jacob T.
Fenton, Brenda T.
Midboe, Amanda M.
Martino, Steve
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2018-03-08Keywords
Chronic painFormative evaluation
Implementation science
Mixed-methods
Opioid
Health Services Administration
Health Services Research
Military and Veterans Studies
Pain Management
Primary Care
Substance Abuse and Addiction
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INTRODUCTION: Opioid prescribing and subsequent rates of serious harms have dramatically increased in the past two decades, yet there are still significant barriers to reduction of risky opioid regimens. This formative evaluation utilized a mixed-methods approach to identify barriers and factors that may facilitate the successful implementation of Primary Care-Integrated Pain Support (PIPS), a clinical program designed to support the reduction of risky opioid regimens while increasing the uptake of non-pharmacologic treatment modalities. METHODS: Eighteen Department of Veterans Affairs (VA) employees across three sites completed a survey consisting of the Organizational Readiness for Implementing Change (ORIC) scale; a subset of these individuals (n=9) then completed a semi-structured qualitative phone interview regarding implementing PIPS within the VA. ORIC results were analyzed using descriptive statistics while interview transcripts were coded and sorted according to qualitative themes. RESULTS: Quantitative analysis based on ORIC indicated high levels of organizational readiness to implement PIPS. Interview analysis revealed several salient themes: system-level barriers such as tension among various pain management providers; patient-level barriers such as perception of support and tension between patient and provider; and facilitating factors of PIPS, such as the importance of the clinical pharmacist role. CONCLUSIONS: While organizational readiness for implementing PIPS appears high, modifications to our implementation facilitation strategy (e.g., establishing clinical pharmacists as champions; marketing PIPS to leadership as a way to improve VA opioid safety metrics) may improve capacity of the sites to implement PIPS successfully.Source
Addict Behav. 2018 Mar 8. pii: S0306-4603(18)30120-5. doi: 10.1016/j.addbeh.2018.03.009. Link to article on publisher's site
DOI
10.1016/j.addbeh.2018.03.009Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46723PubMed ID
29576479Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/j.addbeh.2018.03.009