Welcome to the NAVIPPRO Signal.
This newsletter is intended for professionals in the pharmaceutical, public health, and federal and state regulatory sectors who are involved in education, surveillance, intervention, and risk management for opioid analgesics and other schedule II and III therapeutic agents. We hope you find this issue of NAVIPPRO Signal is useful. If you have any questions about NAVIPPRO or our research, please feel free to contact us.
2nd Annual Scientific Meeting
Some of you will be joining us for the Second Annual NAVIPPRO Scientific Meeting, A Comprehensive System for Prescription Drug Abuse Surveillance and Intervention —New Findings, on March 28, 2012 in Rockville, MD.
We’ll be sharing our ongoing research on topics including:
The slide and poster presentations from the meeting will be available on the NAVIPPRO website following the conference.
Managing Chronic Pain: What Do Primary Care Physicians Need To Know?
Primary care physicians (PCPs) are faced with the challenge of treating a great proportion of chronic pain patients, but most do not have specialized training in the assessment and management of chronic pain, or in the use of opioid analgesics for chronic pain management.
Recognizing the significant role prescribers can play in reducing the risk of addiction, unintentional overdose, and death from the misuse and abuse of opioid medications, the U.S. Food and Drug Administration (FDA) has made prescriber education a central part of its Risk Evaluation and Mitigation Strategy (REMS) requirements for manufacturers of long-acting and extended-release (LA/ER) opioids.
The FDA’s draft prescriber education blueprint for the Risk Evaluation and Mitigation Strategy (REMS) LA/ER opioids calls for continuing education-format programs that support prescribers’ ability to:
At Inflexxion, our NAVIPPRO researchers recently investigated the question of what skills and training PCPs need to prescribe opioids safely and effectively to patients with chronic pain. They wanted to uncover what education physicians would find most relevant to clinical practice, and what would resonate with them most.
To find out, the researchers interviewed a panel of nationally-known experts in primary care, pain management, and addiction about the knowledge and competencies they believed was most important for treating chronic pain safely and effectively in a primary care setting. A content-mapping analysis identified ten discrete areas of concern. The next step was to analyze the priority the panelists assigned to each concept, and look at differences between the priorities of the pain specialists on our panel and compare them to those of the PCPs. The results are below in the order of importance assigned by PCPs. (The priority rank assigned by specialists is in parentheses.)
The panel members agreed on the concepts assigned highest and lowest priority, but on other elements, the skills PCPs thought their colleagues needed most, and those pain and addiction specialists believed PCPs should have, diverged.
PCPs were more concerned that their peers understand aberrant drug-related behavior, how to monitor compliance to therapy, and how to ensure safe and appropriate prescribing of opioids than the specialists. Specialists placed greater emphasis on PCPs being able to formulate a treatment plan, have an understanding general pain management, and be able to teach medication safety than the PCPs.
The topics serve to outline a curriculum of continuing education for PCPs on chronic pain management with chronic opioid therapy that covers both their own perceived weaknesses and the weaknesses observed by specialists, who are more likely to see cases in which primary care was insufficient.
As pharmaceutical manufacturers and continuing education providers move forward on developing education with the goal of meeting FDA concerns about the safe use of LA/ER opioids, understanding the skills and competencies needed in primary care can have a tremendous positive impact on public health.2
(You can see the full report of this analysis in the Fall 2011 issue of The Journal of Continuing Education in the Health Professions.)
New ASAM policy on medication diversion, misuse, and addiction
In January, the American Society of Addiction Medicine issued a new public policy statement on measures to counteract prescription drug diversion, misuse, and addiction.3 The statement calls for mandatory prescriber education covering “the general principles of prescribing drugs that are commonly associated with misuse, dependence and addiction” and including “how to recognize and appropriately intervene in the case of such findings.”
The policy also calls for improved patient education, changes to medical school curriculum, and increased use of state prescription drug monitoring programs.
References
1. US Department of Health and Human Services, Food and Drug Administration. (2011). Blueprint for Prescriber Continuing Education Program. October 25, 2011. Available at: http://www.fda.gov/downloads/Drugs/DrugSafety/InformationbyDrugClass/UCM277916.pdf
2. Chiauzzi E, Trudeau KJ, Zacharoff K, Bond K. (2011). Identifying primary care skills and competencies in opioid risk management. Journal of Continuing Education in the Health Professions. 2011; 31(4):231-240. Available at: http://www.jcehp.com/vol31/3104_chiauzzi.asp
3. American Society of Addiction Medicine. (2012). Public Policy Statement on Measures to Counteract Prescription Drug Diversion, Misuse and Addiction. Available at: http://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2012/01/26/measures-to-counteract-prescription-drug-diversion-misuse-and-addiction
About NAVIPPRO
The National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) is a public health-oriented risk management solution that integrates key components of an effective Risk Evaluation and Mitigation Strategy (REMS): national, real-time, product-specific surveillance; signal detection; and empirically validated prevention and intervention programs.
- 2nd Annual Scientific Meeting
- Managing Chronic Pain: What Do Primary Care Physicians Need To Know?
- New ASAM policy on medication diversion, misuse, and addiction
- References
- About NAVIPPRO
Contact
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The NAVIPPRO team gratefully acknowledges the support of the National Institutes of Health in the development of NAVIPPRO.
The contents of this newsletter are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis or treatment. Reliance on any information provided in this newsletter is at your own risk.
You should consult your physician or other qualified health provider if you have questions about a medical condition. If you think you have a medical emergency, call your doctor or 911 immediately.
©2012 Inflexxion, Inc. All rights reserved.
